Caribbean Medical Schools: A Good Option?

Last Updated on June 27, 2022 by Laura Turner

Because the competition for admission to medical schools in the United States is extremely strong, many applicants consider attending medical school in the Caribbean. In fact, a great many bright and talented applicants are now opting to obtain their medical education in the Caribbean.
How can you decide what is the best choice for you? What must you consider in evaluating these schools? And will you be able to obtain a residency in the United States after you graduate? To help you decide if attending a Caribbean medical school is a good choice, this article provides a framework for evaluating these schools and the success of their graduates.

A Little Background

In the last four decades, the Caribbean has seen a steady increase in the number of medical schools on the islands as well as the size of their student bodies.  In the late 1970’s three Caribbean medical schools were established: American University of the Caribbean, originally located on the Island of Montserrat, Ross University on the Commonwealth of Dominica, and St. George’s University in Grenada.   Since their inception, these schools have educated many US citizens seeking a medical education outside the US,  and now about 60 medical schools in the Caribbean are listed in the Foundation for Advancement of International Medical Education and Research (FAIMERs) International Medical Education Directory (IMED).
The physicians who graduate from Caribbean medical schools play an increasingly important role in the US health care system by supplying residency programs with qualified applicants and helping to meet a well documented physician shortage, particularly in primary care medicine.  While accreditation, didactic studies (first and second years of medical school), and clinical rotations (third and fourth years of medical school) differ among institutions, requirements for graduate certification in the United States, as outlined by the Philadelphia based Educational Committee on Foreign Medical Graduates, are the same for all students graduating from all international schools, including the Caribbean.

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Caribbean Medical School Accreditation

An article by van Zanten et al published in the June 2009 edition of Academic Medicine reviews some of the processes by which Caribbean medical schools undergo external quality assurance.  Accreditation for Caribbean medical schools is on several levels, including local Ministry of Health accreditation by some  individual Caribbean country’s government, regional accreditation by organizations such as The Caribbean Accreditation Authority for Education in Medicine and Other Health Professions (CAAM-HP). The World Health Organization (WHO) does not accredit medical schools but maintains a list of schools that are recognized by local governments. In the United States,  The National Committee on Foreign Medical Education and Accreditation of the US Department of Education (NCFMEA) of the United States Department of Education determines whether the process conducted by an accrediting organization is comparable to the Liaison Committee on Medical Education (LCME) process of accreditation. This is a voluntary process so not all schools undergo this evaluation. If a school’s accreditation is deemed comparable to the LCME process, then that country can apply for US federal loans for those students. Currently, only 3 schools in the Caribbean are eligible for these loans.
California, Florida, New Jersey, and New York require individual school review and approval for Caribbean students to do rotations in that state.   In California, not only must the individual school be approved for clinical clerkships but the student’s clerkship and course work must be approved by the state medical board to obtain residency and subsequent physician licensure.  Any deficiencies in clinical training, as determined by the state, may need to be remediated to practice in California.  Many other states defer to California’s approval for the purpose of licensure because most do not have their own approval process. Also of note, New York has the largest number of international medical graduates in residency training and about one third of residency programs in the US are located in the state of New York.
It is important to know which organizations have accredited any school you consider attending.  Knowing if the state in which you intend to practice recognizes your school is also important.  Caribbean medical schools proudly display these accreditations on their websites so if an accreditation is missing, be wary.

Quality of Medical Education in the Caribbean

Another recent study by van Zanten and Boulet published in Academic Medicine examines the quality of medical education in the Caribbean. The report finds tremendous variability in both the quality of undergraduate medical education and in students’ performance. The only way to evaluate the education Caribbean medical students received was to examine students’ scores on the United States Licensing Exam (USMLE) Step 1, which is taken after the second year of medical school. Investigators calculated the average USMLE Step 1 first time pass rate for each country in the Caribbean. In evaluating this data they also took into account that some islands have more than one medical school.  The countries with the highest percentage of students passing the (USMLE) Step 1 on the first attempt were Grenada (84.4 %) and Dominica (69.7%). Countries with the lowest pass rates were Saint Lucia (19.4%) and Antigua/Barbuda (22.9%).

Preclinical Years

Students typically spend the first four to five semesters of medical school in the Caribbean completing basic science courses before taking USMLE Step I.  Basic science curriculums in the Caribbean are similar to US curriculums.  Some schools offer a fifth semester, either in the Caribbean or in the US, to help students prepare for the USMLE Step 1 and transition to their clinical semesters.
Living in the Caribbean can present many challenges for those who have never lived outside the United States. For many students, it will be their first time away from the United States for a prolonged period of time. Many of the luxuries found in large US cities, such as restaurants, movie theaters, shopping malls, and commercial gyms, are not available on the islands, and friends, family, and religious support groups are thousands of miles away. On the plus side, many students form strong relationships with classmates and also enjoy learning about the history and culture of the local West Indian population. Former students also have fond memories of celebrating yearly holidays such as Carnival, the colorful, festive, and historical event celebrated annually throughout the Caribbean.
After successfully passing the USMLE Step 1, students proceed to their clinical rotations, which usually are outside of the Caribbean.  When evaluating schools, it is important to ask what percentage of students who initially enroll in each class actually take and pass the USMLE Step 1 and successfully proceed to clinical rotations.

Clinical Years

Core clinical rotations and third and fourth year curriculum in Caribbean schools resemble those of US medical schools. Caribbean schools that offer clinical training in the US have strict guidelines about the location and quality of students’ clinical training.  All core rotations and subinternships must be completed in hospitals with which the Caribbean medical school has an active, written affiliation agreement and which have appropriate clinical faculty members. Rotations must be approved by the Accreditation Council for Graduate Medical Education  (ACGME). In addition, it is preferable that hospitals have approved residency training programs (or their British equivalents) in the specialties through which students rotate.  Students also take both parts of USMLE Step 2 (clinical knowledge and clinical skills) after the third year.
Hospitals in which electives are taken should also have approved postgraduate programs in those specialties.  For example, it is best to do an anesthesia elective at a hospital that has an anesthesiology residency. Regardless of school affiliation, however, individual hospitals still reserve the right to screen individual students for elective clerkship acceptance. Some individual hospitals and departments do not accept international rotating students, which can limit the away electives in which students can participate. From a competitive perspective, it is always preferable to participate in clinical rotations located in hospitals that not only have ACGME accredited residency programs but are academic teaching hospitals rather than community hospitals.

If I Go To a Caribbean Medical School, Can I Get a Residency?

Graduates of Caribbean medical schools have tremendous success in obtaining residency positions, even in competitive specialties. It helps to attend a well-established Caribbean school, perform well on the USMLE Steps 1 and 2, and obtain strong letters of recommendations. (See my previous articles: Getting Into Residency Part 1 and Part 2 for more information.) Before applying for the residency match and early in medical school, students should strategically plan their clinical clerkships in the US, ideally arranging rotations in the settings where they prefer to match.  In recent years, Caribbean students with strong academic and clinical performances have been able to obtain competitive residency positions at an increasing rate.  However, the largest number of students pursue less competitive specialties, such as internal medicine or family practice.  Some students are also able to ”prematch” into residency positions outside of the National Resident Matching Program (NRMP).
When evaluating the success of a Caribbean medical school’s graduates, it is important to find out specifically where and in what specialties students match. Also determine what percentage of fourth year students match into categorical programs. This information may not be easy to obtain. While schools typically publish their match results, it is unclear if these lists are truly comprehensive.
After residency, Caribbean medical students, along with their domestic colleagues, will obtain board certification and must meet specific requirements for state licensure. The quality of one’s residency training usually carries more weight than the medical school attended, so obtaining the best possible residency and even fellowship can help Caribbean students overcome some of the bias foreign students face when competing for competitive attending positions.

Educational Commission for Foreign Medical Graduate (ECFMG) Certification and Graduate Medical Education Programs

To be eligible for ACGME accredited residency programs in the United States, and for licensure in many states, students who graduate from a Caribbean medical school must obtain an ECFMG certificate. Eligibility for this certificate includes graduating from a medical school listed in FAIMERs online International Medical Education Directory (IMED) and passing the USMLE Steps 1 and 2 (both clinical knowledge and clinical skills).  For more details, see the ECFMG website at

Questions to Ask

School History

  • When was the school established?
  • What percentage of students are US citizens?
  • By whom is the school run and what are the credentials of the academic faculty?
  • Has the school had any recent changes in leadership? Are any leadership changes expected?

Caribbean Medical School Accreditation

  • By whom is the school accredited and is the school accredited by the states of California, Florida, New Jersey, and New York?  Is the school listed in FAIMER’s IMED?

Admissions, Medical Education and Curriculum

  • The quality of your medical education begins with the advice you receive prior to attending a Caribbean medical school. Is your premed advisor well versed in the pros and cons of attending medical school in the Caribbean?
  • If interviews are required, by whom are they conducted – alumni, administrative staff, faculty and/or current students?
  • What are the mean overall and BCPM (biology, chemistry, physics and math) GPAs and MCATS of accepted students? Are MCATs required to submit an application?
  • Does the school have more than one matriculating class annually and are admissions rolling? Unlike most US schools, Caribbean medical schools typically have two to three first year classes that begin at different times during the academic year.
  • What is the average size of each entering class? Does the size vary depending on the start date?
  • How many students enroll in each first year class? What percentage of students who enter as first year students start third year rotations as scheduled?  What percentage of first year students match into categorical residencies in the United States during their fourth year? What percentage of first year students graduate? (Understand that graduating does not necessarily mean matching, so both of these questions must be answered.)

Financial Concerns and Living Conditions

  • Do most students fund their education using outside loans or scholarships? Are these loans backed by the US government or are they private loans? Does the school offer financial guidance to help students choose the best loans and make responsible financial decisions?
  • Where do students live and what are the housing conditions? Does the school provide housing?

Clinical Studies

  • Where do students do their clinical training? Can students choose where they do core rotations? Are the rotations ACGME accredited? Do students work alongside US medical students?
  • Are students allowed to do elective rotations? How many? Can students do away electives at nonaffiliated hospitals? Does the administration or faculty help students obtain away electives?

Residency Match and Professional Guidance

  • Does the school provide guidance to help with the match process? Do students have an assigned advisor to help them?
  • Where and in what specialties did students in the most recent graduating classes match for residency, and what percentage of fourth year students matched into categorical residencies?
  • What percentage of students do not match annually? What percentage of students must enter the “scramble”? For students who enter the scramble, does the school provide assistance to find an unfilled residency spot?

Alumni and Student Support

  • Where do alumni practice geographically, in what specialty and in what type of practice (community or academic)?
  • Will the school provide contact information for alumni and current students with whom to speak?

Medical School in the Caribbean

Going to medical school in the Caribbean can be a good option as long as you do your research and make an educated choice. The medical education you will receive in the Caribbean varies tremendously, and the success you will have after graduation depends on many factors. Attending a top Caribbean medical school is a great option for some students but, just as for US medical students, once in school you must “do the right thing” to secure an excellent residency, (See my article Getting Into Residency Part 1 and Part 2.) I have had several Caribbean medical student clients earn residencies in competitive specialties, including anesthesia, emergency medicine, and internal medicine so, yes, it can be done!
Jessica Freedman, MD, a former medical admissions officer, is president of MedEdits (, a medical school, residency and fellowship admissions consulting firm. She is also the author of the MedEdits blog, a useful resource for applicants: (
The author would like to thank Marta van Zanten for clarifying parts of this article.


1) van Zanten M, Boulet J R. Medical education in the Caribbean: variability in medical school programs and performance of students. Academic Medicine. 2008;83: s33-s36.
2) van Zanen M, Parkins LM, Karle H, et al.  Accreditation of undergraduate medical education in the Caribbean: report on the Caribbean accreditation authority for education in medicine and other health professions. Academic Medicine. 2009;84: 771-775.

242 thoughts on “Caribbean Medical Schools: A Good Option?”

  1. For applicant’s that do not gain entry into a US allopathic school their first time around, would you consider Caribbean schools as being a better alternative to osteopathic schools if one primarily concerned with being able to practice in the US in a slightly competitive sub specialty?

    • No. There are three reasons that US schools should always be preferable. First, only four Caribbean medical school quality for federal student loans. Without such loans, students must find several hundred thousand dollars of tuition. Two, the level of teaching differs greatly. Step 1 and Step 2 ck and cs are brutally difficult. Without rigorous teaching, students won’t pass them on the first or ever. This is the single most important criteria in getting into residencies. Three, there is a real bias against Caribbean schools. I called a number of residencies. Many were forthright and said that they preferred US citizens from US schools. While they didn’t mention DO schools, the implication was straightforward. Key factor: DO from the US are routinely granted licensure. Same is not true for Caribbean graduates.

  2. This is a wonderful article. In my experience, the big three schools, AUC, RUSM, SGU are just as good as many LCME-accredited domestic schools and much of the training takes place in the US (2/3). I also agree that getting a great residency/fellowship program is more important than where one attended medical school. Great Job!

    • The three schools listed above qualify for federal student loans. Ross graduates in general are generally given a lot of respect. Their level of Step 1 pass rate is pretty high. Yet, Ross accepts hundreds of student each semester. It would not be unheard for them to accept nearly 2000 students on a yearly basis. By comparison, US schools accept fewer than 200 per year. Further, Caribbean schools seek core rotations for their students in the same manner that US schools. Although Ross has been extraordinarily assertive in procuring rotation sites, many of them do not have residencies associated with them in all the core rotations. The point is that Ross University accepts students who do not succeed in their studies. Although Ross does not disclose the numbers, logically, 75% of all students Ross do not succeed. It can be stated that Ross gives many students a second chance. However, many of these students have no business being in medical school. Ross does not do a good job in screening applicants judging by the fail rate.

  3. Caribbean medical schools shows us how competitive America is for jobs and how much harder it’s becoming with the current economic climate. Smart people are going back to medical school since they realize they should be as qualified as possible to find a guaranteed job.

  4. Tom,
    going to an osteopathic school is a much better option than even the best caribbean school unless you are hung up on being an M.D.

    • I could not agree with you more….after being in the caribbean system and the struggles you face at each level from quality to the aura surrounding a caribbean student… is only for those who are extremely strong willed at becoming a doctor. It sucks when you have to take a back seat to an american medical student……it almost takes the prestige away from that title of an MD….those long for.

  5. I am impressed that the author of this article did not consider Puerto Rico as part of the “Caribbean”. As a matter of fact, Ponce School of Medicine in south Puerto Rico has a fair amount of students from the United States. In addition, the passing rate for the Step 1 is around de high 80’s and many students obtain competitive residencies in the United States. In Puerto Rico, there are 4 Schools of Medicine of which 3 are private and 1 is Public (Medical Sciences Campus of the University of Puerto Rico).They all are LCME accredited. Please consider doing further research on this topic for those United States students that have an erroneous perception of Caribbean Medical Schools. As a nice example, please look who was this year’s highest grade in the Neurology Board Certification Exam, you will be surprised…

  6. Juan Del Pueblo: the article didn’t mention Perto Rican schools as part of the caribbean because these schools are LCME certified and considered not foreign, i.e. part of the US allopathic school system.. you’re not considered a foriegn medical graduate or international medical graduate if you graduate from a puerto rican school… remember puerto rico is a US territory.

  7. I would NEVER consider going to a Caribbean school. I went to a state funded school and am in ENORMOUS debt. If you are doing it “to get a job” or “make yourself more marketable”, you are DEFINITELY doing it for the WRONG reasons. You must REALLY, TRULY want to be a doctor for all the right reasons…altruism etc. to even consider a Caribbean school. You will have to work twice as hard as your LCME peers and pay twice as much for the education. If you end up doing it for the wrong reasons, you will be very bitter when your $2000+/month student loan bill comes and you are making $60,000 as a pediatrician because that’s the only residency you could get into…. Just something to think about!

    • Believe he meant pediatric “resident,” and trust me, residents do not make the full-blown wages that an MD who has finished his residency or fellowship does

  8. uh..yeah..john’s right.
    But this article is great! I was looking to find some compiled info on Caribbean schools. I mostly hear negative things, like you must be really dumb if you go to a Caribbean school. But this article doesn’t really mention anything about living conditions, I have heard that its pretty rough…?

    • The living conditions vary. It is expensive to ship in many items to small islands. On some islands even the larger schools, the living conditions are difficult both expensive and limited. However, most students endure difficult conditions because of the single focus on completing coursework and passing the Step exams.

  9. Ana:
    To make up for the slightly lower admission standards, reputable medical schools like Ross Univ., SGU, AUC utilize a faster pace, more challenging, but not impossible, curriculum to ‘balance’ things out. Additionally, all Carribbean medical graduates must pass the ever challening USMLE exams (1,2, CS) prior to residency. And one cannot be ‘really dumb’ to pass these challenging exams. 🙂
    The most expensive Carribbean medical school, SGU, costs the same as the majority of private LCME accredited medical schools. And no, pediatricians do not make 60K annually. You may have met one who works part-time (2 days per week).
    Having personally witnessed DOs at my hospitals over the years struggled with some of their patients, staff, colleagues regarding their DO status; I’m very glad I chose the quality Carribbean MD route. Everyone I know from my medical school (RUSM) matched into the residencies he/she wanted, are now board certified, and helping people in their communities.
    Bottome line is that there are tens of thousands of Carribbean medical graduates in the US providing quality health care in the EDs, outpt clinics, running clinical research labs, rounding on the medical/surgical/psychiatric wards. And many have probably treated your family/friends when they needed us the most. If it wasn’t for these folks, the physicians shortage in our country would be even more dire.

  10. Like Richard I attended medical school in the Caribbean. I was surrounded by bright and interesting peers and we went on to have great careers in medicine. We as a group are helping to alleviate the doctor shortage in this country.
    Path: I work as a pediatrician in a large New York City hospital and all of us make between $130,000 – $150,000 annually.
    I work alongside graduates of allopathic US schools and Caribbean graduates and I experience no stigma regarding my degree. I am valued and judged on my clinical skills and knowledge – not by where I went to school. I am happy to say that I received a great medical education, residency training and I now have a thriving career.
    The author of this article, Dr. Jessica Freedman gives great guidance in this article and her positive tone reflects that those in higher education are not only accepting of but also embrace those who graduated from the Caribbean. Thank you.

    • Hi Williams,
      Is it possible to become a cardiologist after completing this MD in carribean ????? hope u’ll help me out in this..
      Thank you.

      • Yes it is. Admittance in a residency program in a specialty field is competitive regardless of where you did your book work. Good luck

  11. To the poster about Peurto Rico being an option. Reason writer doesn’t mention PR is because PR schools are LCME accredited. Thus these people do not need ECFMG certification, and are NOT considered foreign medical graduates. This is why PR is not listed, b/c going to a PR school is the same as going to a school in the US in the eyes of Residency Directors. Also PR schools are just as hard to get into as US. Point of most caribbean schools is those with stats just below us Allopathic can still have a shot of becoming a doctor because the US doesn’t have enough med school seats for them.

  12. Daniel: Actually PR schools are definitely not as hard to get into as compared to the rest of the US allopathic schools. Taken from the 2010-11 MSAR; San Juan Batista School of Medicine Ave GPA: 3.3 Ave MCAT 20….Ponce School of Medicine Ave GPA:3.6 Ave MCAT: 21…. Those are only 2 of the schools, but as you can see have a MCAT average is way lower, generally 5-6 pts below the ave MCAT at any given osteopathic school, and about 10 pts lower than other us allo schools. I believe this is simply due to the fact that you are required to be fluent in Spanish to be admitted at PR schools, which not that many people are.
    Richard: I’m not sure what DOs you observed, but the DOs I’ve shadowed (ortho and derm) were very happy with their education and “DO status” as you put it (whatever that means).
    No matter what route you go (osteo, us allo, caribbean allo), it’s really all about: how hard you work, that you make the most of your education, and you love what you do because that’s what will make you a great doctor.

    • To clarify, an important reason as to why the PR MCAT Ave. Is somewhat lower than in the USA, is that Spanish is the main and first language of PuertoRican students. Even tough they know English, they are in a different language level as compared to the students in the USA. You are right in saying that you have to be fluent in Spanish in order to be accepted to a PR school of medicine

  13. Very good article – definitely helpful for anyone considering a Caribbean medical school, which is probably a great alternative for many. I am a US MD student, but know two physicians, who graduated from Caribbean med schools. Both are highly competent doctors, and one of them is even the director of her hospital’s OB/Gyn department. Few people know that over 20 percent of physicians in the US were educated outside the US. Once you’re practicing, nobody ever evaluates you based on where you went to medical school – an MD is an MD.

  14. John,
    Having trained in emergency room medicine,i’ve had the opportunity to train and interact with hundreds of MDs/DOs over the years. I also worked with DOs during my fellowship. As an attending, I’m now supervising some trainees who are DOs. As you know, medical training is intensive so I basically have lived and breathe with these people for many years. Superfically, people may appear ‘happy’ when you interact with them for a short time, i.e., shadowing, but this may not be always how they really feel. In general, I believe osteo. schools produce terrific DO physicians but I do not believe this alternative route has all the advantages some claim it has over the well-established, high quality Carribbean medical schools ( RUSM, SGU, SABA, AUC.).

  15. Wow this article and most of the comments are encouraging. I’m headed down to SGU in a couple of weeks and have been a little nervous about residency placement. At least now I know it can be done. Thanks.

  16. For those of you that attended AUC, Ross or SGU…I have type 1 diabetes and I was wondering what the health care/clinics were like. I appreciate any insight.

  17. Tom, you and other people with personal health issues, who are considering Caribbean medical schools might want to look at AUC in particular. My friend goes to AUC and he says that the island is probably the most developed in the Caribbean, and provides a very americanized/europeanized living environment. St. Maarten has hospitals, private doctor’s offices, pharmacies etc., and some of the island’s amenities are even better than in most parts of the US.

  18. Richard,
    How would you rate the top DO schools (PCOM, CCOM, Western) against the top Caribbean schools. Having been accepted to both programs (US MD and DO), I think it is really naive of you to suggest that osteopathic programs produce physicians with any less advantage/opportunities than their allopathic counterparts. WVSOM has been consistently ranked as one of the top medical schools in the country for primary care. By law US DO= US MD but that does not go for Caribbean grads. If one of your arguments is that DO’s find it hard to specialize then I suggest you look at some recent match lists of schools such as LECOM-Bradentom and UMDNJ-SOM. If another one of your arguments is that DO’s are not recognized internationally then I suggest that by looking into it further you will see that the D.O. is recognized in 45 countries and that it is not easy for a physician regardless of title to set up shop anywhere in the world. I have worked my ass off to get into an american medical school and have friends that did not even take the MCAT and got into places such as ROSS and SMU in the Caribbean. I have a cousin that was expelled from school and arrested for drug related charges but was accepted into a carribean medical school. So Richard I hope you get off your high horse and give some reasons why you think a Caribbean grad has more advantages than an American DO grad.

  19. I think a physician is a physician and its all about your knowlege and rapport with your patients that matters. The DR in OHio who was credited with the first facial reconstructive surgery ( plastic surgeon) is an IMG…..same as numerous reputable doctors produced from schools outside the United States. As far as carribean medical schools, the most reputable once i can speeak for ….ross, auc, stgeorges and saba. I agree with Dr Freedmann that residency is what it all comes down too. I have seen students from these medical school match into competitive specialty and yes even neurosurgery, opthalmology e.t.c. Sunny upstate has a guy from Ross in their neurosurgery program who is a chief resident.
    In regards with kevin’s post Dos are medical doctors and i dont think the field of medicine has any inferiority or superiority to it ….although Dos are medical doctors in the States ..osteopathy is a different field of health care in other country which might pose some kind of misconception with the country’s medical board. Lastly Ross, SGU and AUC requires the MCAT and by the way surprisingly these schools numbers have been going up recently. I know SGU has numbers close with lower tier MDs and DO stats …same with ross ……you do have to do your research when you choose medical schools either way …..sgu, auc , ross , saba …seems legit to me.

  20. Jude…I agree that hard work, good letters of rec and board scores will help any applicant get a competitive residency but the fact is that being an American graduate with the criteria listed above will put you above an FMG with the same credentials. The only school that I know has a competitive applicant pool is SGU. I have four friends currently at ross with mcat scores ranging from 14-18 and low GPA’s but I understand that getting in is not the hard part…its staying there. As for DO’s international practice rights I’m glad you understand that osteopathy is not the same thing as osteopathic medicine and in order to practice in other countries you have to go through alot of red tape and examinations regardless of being an M.D. or D.O. (for example in England you have the M.B.B.S. instead of M.D.). Another thing that applicants looking to apply to foreign medical schools should consider are the huge class sizes that might make it tough for some students to reach their academic potential. If you look at the match lists for SGU this year you will notice that out of the huge number of students only a tiny minority got into competitive residencies while 0 got into radiology.

  21. Kevin, I have personally spoken to chairs of several residency programs and they all said that it really does not matter if one is a US grad or a FMG. Some residency programs do strongly recommend at least some US clinical rotations, which is done by all Caribbean MDs, where all clinicl rotations are in the US, as well as by many other FMGs.
    What is actually much more important for residency is your academic performance, USMLE scores, and letters from clinical faculty. It might be that you have friends at Ross with low credentials, but the fact is that the top Caribbean schools (SGU and AUC) have average MCAT scores that are actually higher (26 and 25 respectively) than those of the majority of DO schools.
    Also, you are wrong about the international differences in medical degrees. An M.B.B.S. equals an M.D….period – when a let’s say British or Australian medical graduate earns his/her ECFMG certificate after passing all steps of the USMLE, the M.B.B.S. gets automatically converted into an M.D., as both degrees are internationally recognized as the same….only the spelling is different. “Doctor of Medicine” gets abbreviated differently in different countries – Another example is Germany, where it’s When a German physician comes to the US, his degree simply gets converted into M.D. This is of course not possible with a D.O.
    I have personally never heard of any D.O. practicing outside the US, and I am unfamiliar with the licensing process that this would entail. It makes me generally upset when people regard non-US medical degrees as inferior considering that some of the world’s best medical schools are in Europe, Israel, Australia etc. Thinking that US-trained physicians are superior in any way is very closed-minded and ignorant.
    I don’t believe that there is anything wrong with getting a D.O., especially if you are planing to go into primary care, and do not intend to pursue allopathic residencies and fellowships. You need to understand, however, that many people simply don’t want to be a D.O. out of different reasons. It is a nontraditional medical degree, which will make you different from 99.9 percent of doctors in the world. Also, it’s philosophy and curriculum are not for everyone.

  22. Carl,
    You might have talked to chairs of several residency programs but it does matter in general in the united states if you are a graduate of one of its medical schools or one that is foreign. You cannot possibly argue that a foreign medical student with the same credentials will get a residency position over an american graduate…it will never happen. An american MD cannot just move to england and start practicing medicine, he/she has to pass the plab exams in order to get certified. Germany is actually one of the 45 countries that recgonizes the D.O. degree and will grant full practice rights and you can check with the AOA with the full list of countries granting D.O.’s full practice rights (remember osteopathy is totally different from osteopathic medicine). As I mentioned before you CANNOT just go abroad as an MD and start practicing anywhere in the world that you like…you have to go through each nation’s certification process and there is no country in the world that would reject an american medical graduate and for your information MOST of the Caribbean schools are not recognized in Europe so forget about international practice rights…I think SGU grads are the only ones able to go back to practice in england. I do not doubt that the “top” caribbean schools are getting more competitive to get into but the numbers you provided are sorely misplaced (most likely from the school itself)…the schools are all profit based and will hand over admission to whoever has the deeper pocket. As for D.O.’s practicing outside the U.S., I have shadowed numerous D.O.’s that practice both in the U.S. and abroad…as I mentioned before that being an american graduate will open doors anywhere. Your statement that D.O.’s have a hard time getting allopathic residences is WRONG…check the match lists of almost every single DO school and you will see that more than a majority of the graduates match into competitive allopathic residencies while the others CHOOSE to do an osteopathic one. Your claim that an osteopathic physician has a “nontraditional degree” is US LAW A US DO=US MD. D.O.’s take the EXACT SAME courses as their allopathic counterparts as well as taking additional courses in osteopathic manipulative medicine. I am not saying that US trained doctors are the best in the world…I am saying that in order to further your career in the UNITED STATES it is better served to attend MEDICAL SCHOOL IN THE UNITED STATES (either MD or DO). There is no need to argue this anymore….going to medical school in the Caribbean should be the VERY LAST OPTION for a student thinking about practicing in the united states.

  23. Kevin, you did not seem to understand the point that people made about the comparison between the two options. The main question here is whether a prospective medical student actually wants to be a D.O. Again, I am attending a US allopathic school, but I know people in both of the two other camps. For all of them I know that it was a second choice, both for the off-shore AND osteopathic folks. If I did not get into a US allopathic school, I would have rather gone abroad than go to a D.O. school, simply because I want to be an M.D. and think that nearly all students at osteopathic schools are not there because they actually want to be D.O.s, but because that’s where they got in. Of course you have many opportunities as a D.O., but so do FMGs. It is crucial to note that not all Caribbean med schools are created equal. A lot of them are not accredited, while two or three of them have had terrific success producing quality graduates. When you look at the facts, you will see that the first-time pass rate of the USMLE1 is higher among students from both St. George’s and AUC versus D.O. schools (~90% vs 82%).
    Regarding the for-profit status, I think a for-profit D.O. school just opened in Colorado last year. Also, no one was saying that it is necessarily harder to specialize as a D.O. than an M.D., but the actual purpose and philosophy of osteopathic medicine places emphasis on primary care, a fact that many D.O.s often like to ignore.

  24. excellent non-biased comments, David and Carl. Having sat on the residency selection committees in residency, fellowship, and now as an attending at NE (not NYC) academic centers, there really is no limit for MDs and DOs regardless of where one went to medical schools. I regularly recommend DOs to my programs if they have good scores, LORs, and engaging. And once in a while, some do match with us and they turned out great. Generally, pre-medical students like Kevin and others tend to think that life as physicians stop when they get the residency of their choice, and then their lives are complete. Unfortunately, this is not always the case as my previous comments were geared toward many years of working with MD vs. DO residents. Just as the BU medical students who had been arrested for murder, surgeons/rad. onc botching procedures, students who got into allpathic med schools with MCAT of 21-23, or the 4’11 guy dating a pretty 5’10 girl; these are exceptions and not the rule. When one looks at the bimodal, bell shape mcat scores distribution there are few individuals with scores on the extreme end ( 14 vs. 43) and most people falls in the middle (20s-30s). I don’t doubt his story of knowing 4 friends with mcat of 14-16 (although he claimed earlier that Ross accepts people without MCAT scores, which is not true) AND having had friends with legal problems admitted to offshore med schools- again these would be rare exceptions and not the rule. RUSM requires a letter of good standing from a local police department, btw. To the best of my knowledge, the average MCAT scores/GPA/etc. schools like RUSM, SGU, AUC (also founders of the colorado DO school!) are accurate as they had to produce evidence when the texas, ny, ca, etc boards of medical educations visited the school recently and found that the medical education provided at Ross is equal to the medical schools in their respective states. I won’t go into the details but there is alot of behind the scene activities between schools like Ross, SGU with organizations like the AMA, sallie mae, us dept of education, etc.. to keep their affiliations with numerous acgme hospitals affiliations and federal loans in the US. Bottom line is that good Carribbean medical schools like Ross and SGU are good option for aspiring physicians and certainly not the last option.

  25. Good comments from everyone. Surely there have been caribbean grads go into neuro, ortho, radiology etc… but these are largely exceptions and I think the author does a disservice by really sugar coating this issue. I have witnessed several FMG’s spend 1-2 years doing research and/or pre-lim years in order to secure surgical residencies and not all received those spots at the end of the day. I think what this article boils down to is, Caribbean MD or DO? If you want primary care it won’t matter, but if you want a competitive speciality in the US, DO is better.

  26. David: you have to understand that not all DO students take the USMLE’s and not all students report their USMLE scores after having taking the exam therefore the 82 percentile pass rate you mentioned is inaccurate. As for almost every DO student being an allopathic reject is laughable. You truly are misguided. There are alot of DO schools with admissions criteria higher or on par with mid tier allopathic schools. There are tons of students that got into both programs like me but chose the osteopathic school because it is where they felt more comfortable. Your comparison of FMG’s being the same as American DO’s is completely false as well. In the United States a D.O. is considered an AMERICAN GRADUATE thus opening more doors to get competitive specialties vs. FMG’s. You cannot argue this point…just go compare match results of the top carib schools vs some DO schools.
    Richard: The people that I know that got into ross without the mcat tranferred from a medical school in england. I do not doubt that the top carib schools might provide an excellent education as you are an FMG yourself but you have to look at statistics in general. As JD stated above me, if a student wants to get into primary care then by all means go to either a DO or FMG program but if someone wants to specialize then the best way is to stay IN THE UNITED STATES (DO or MD).

  27. JD: Based on my experience, Caribbean medical students who have outstanding scores, letters of reference, written documents, interview skills and guidance, can obtain competitive residency positions. Sugar coating aside, Caribbean students who are talented and motivated can excel.

    • They do and will excell. My son is now a 3rd yr resident in Illinois and in a very good residentcy program and never had any trouble with great rotations prior to that. My youngest son is now a second yr med student in a Caribbean school and working his ass off. He too will be successful.
      Good luck to all of you!

  28. Thanks Dr. Freedman for this very thorough and unbiased article. As many people have already mentioned, it is the individual student that makes the difference, not the fact whether one comes from a US med school or is a FMG, or even whether is an MD or DO. DOs do tend to get better residencies on average than FMGs simply because they have the option to go into osteopathic residencies, and the AOA only considers DOs for their own programs. When one looks at allopathic programs only, however, FMGs may even do slightly better than DOs. Please correct me if I’m wrong. Also, wouldn’t a bunch of DO students not reporting their USMLE actually increase their average, since lower scores would tend to not be reported as much?
    Concerning students individual choices, and I have known many pre-med and medical students, and I have NEVER heard of anyone choosing DO over US MD. However, I have heard of several people, who preferred the FMG rather than the DO route.

  29. I think reading the post especially Kevins, we are missing the whole point of medicine which is basically how well you treat, interact and provide care with the best of your abilities with your patients. Remember patient is “key” not school.This will become evident as you are aligned with resident doctors from a wide array of schools …might be FMG, AMG, or Dos. I have recently spoke with some PD about their residency selection and one thing that stuck up was …they do not differentiate for the most part applicant and schools …you do have to talk about your basic science education and the school you went to but in the normal selection of applicants you are compared based on your board scores, research experience, and clinical and basic performance. I read a post once about students from Loma Linda who went for residency interviews and had to explain to the PDs maybe their school was an MD or DO school….this is what normally happens or else your school is well known ., some program directors have no clue about some of the schools., which is where your interpersonal communication comes into place. I think we seem to be missing the point also that 20% of physician workforce in the U.S are IMG/FMG. In the state of Newyork majority of physicians practicing in that state are foreign graduate. Dos like I said earlier are physicians of course but people often struggle with their philosophies…the region I live in …there are very few Dos around here and its sometimes difficult when patients dont know much about DOs being physicians…..but anyways it comes down to you maybe FMG, AMG or DOs. And kevin there is no last resort in medicine…the field is grueling itself …there are so many more decisions you will have to make in the future that might seem like a last resort but its probably the best decision you will make. Lastly when we compare FMGs/IMGs or viewing them as lesser than AMG ..lets not forget that some of the best medical schools in the world even equivalent to our IV leagues are also FMGs. Cambridge medical school in England, Royal college of physician and surgeons in Ireland and trinity college Dublin are also in the list. I dont see any difference btw these schools and the best of school(s) in the United States. I would like to mention also that you might have great board scores and bad interview skills or the other way around …and your chances of matching might some time depend solely on your interview skills.

    • Thank you for that great reply, Dr. Freedman. Also, getting into a us schools is so competitive, that if you get rejected, that doesn’t mean you aren’t good enough to get into a US schools. Its just that there wasn’t enough seats. So, offshore is an option.

  30. I think it is interesting how this has generated a DO vs Carib debate. There certainly is some misinformation going both ways. The majority of DO students are americans and will practice in America…so practice rights in other countries are irrelevent, though most modern countries has a pathway to licensure (the list is online). As for everyone going DO as a second choice, there certainly are those who did not get into allo and so chose osteo, how many will never be known but it is certainly not everyone. Many people certainly like the point of view or they like the manipulation or some combination of both. As for the Carib schools each of those big four post their match lists and instead of stating “carib matches better or DO matches better” compare them. There certainly are many carib students matching to great places in great specialties. However, the attrition for those schools is high (arguably because thats part of their process) and many in fact do match into FP/IM. The DO students do have the option of DO residencies but a high percentage do match to allopathic residencies and fellowship and this can be quantitatively shown that only about half of the DO residencies are filled…the rest of the classes went allo. So to say they have no chance or little is incorrect and misinformation and many of the better DO schools (PCOM, the state based ones OU, UMDNJ, OSU; DMU, COMP and NOVA’s list was also great) show a high percentage of competive specialites and IM matches.
    Someone above remarked that DO is for primary care and that specialties are hard to get, it is true that DO schools seem to push primary care as their mission, however so do about a large amount of MD schools as everyone tries to fill the “primary care gap” the students say “ok” and do the best they can and go into what they feel matches them and what they are competitive for. I think that overall whether you went UsMD, UsDO or carib you try to do the best you can. Some residencies do like DO’s, some dont like IMG, some dont care. I personally had an MD acceptance but chose DO because I like the patient centered approach, whereas the carib for me personally was not an option because i felt it was 100% a “2nd” option.
    I intend to take the USMLE though many allo residencies are currently accepting COMLEX as well. I am also interested in pursuing internal medicine and a cardio fellowship. Before I get a million comments about it will be difficult remember that nearly ever DO cardiologist (there are plenty according the ACC website) went to allopathic residency and fellowship as there have only recently been osteo-only cardio fellowships…and this can be generalized to just about every osteopathic phyiscian who is a fellowship,
    Lastly..I doubt that most patients care, the DO’s that I know have been asked little in their career and remark that the only people who care are pre-meds. Most people see “physician” and thats the end of it.
    Son of a DO allopathically trained interventional cardiologist and current DO student.

  31. I would like to amend what i wrote due to my iphones annoying habit of replacing words..
    When talking about was “some DONT like DO’s, some DONT like IMG, Some DONT care”
    And with regard to generalizing to other DO specialist being allopathically trained (yes there are many specialty osteo residencies that train well) it should have read “every other osteopathic physician who is HAD a fellowship” instead of how “is a fellowship”
    sorry…blame apple

  32. All this talk of Caribbean Medical Schools being no good is quite crappy. People who go to these universities are not dumb! Caribbean students are very smart! Its just that they cannot afford better university education. I have 15 friends who applied to MIT and they all got admitted on their A-level results…they never went because they couldnt afford it. I did 12 subjects (English Language, Literature, Math, Physics, Chemistry, Biology, Human Biology, Information Technology, Geography, Agricultural Science, Spanish and EDPM) at CSEC (yes 12!) and I am currently doing 7 A-levels (Biology, Chemistry, Physics, Mathematics, Further Mathematics, Psychology and Astronomy) and i plan to attend a Caribbean Medical School. I also did up to Grade V in Music Theory and Practicals. I did SAT2 – Biology (760), Chemistry (800) and Physics (780). I am a volunteer at an Orphanage, I am a champion debator and i have written 67 poems (i have not published as yet) in standard english, Shakespearean English, Creole and Spanish. Am i dumb?? My friends are all just a tad behind me…are they dumb?

  33. With regards to attrition rates, this discussion should be reserved for people who complete their four years of medical education, and pass their USMLE exams. To use attrition as a criticism of a school to me is silly. The schools are accepting some people with non-stellar academic backgrounds, and giving them the opporunity to get back in the race by passing their courses and their steps. If they can’t make it, that is certainly no fault of the school
    With regards to living conditions, I think this is pretty subjective, and in my 20 months in St. Maarten, I had no complaints at all. In fact, I often yearn for the beach and a cold drink.
    Academically, the basic sciences at the big 3 schools focus on 2 things, preparation for Step 1, and preparing students for the wards (just as U.S. schools do). And if a Caribbean student has passed the USMLE exam, and can function in clerkships (many times alongside U.S. students), then the school has done its job.
    If in the rotations alongside U.S. students, we learn patient care to prepare us for residency, and the knowledge to pass step 2 and shelf exams (all of which U.S. students do), then the schools are doing the same job U.S. schools do.
    There are three areas of inferiority I do see:
    First is the stigma. People say “oh, this guy must be an idiot, his GPA in undergrad was only 3.3, how can he be a good doctor if he didn’t get accepted to a U.S. school?”.
    Second is the lack of an academic/research envronment. Caribbean schools are USMLE oriented, not research oriented, which makes it very difficult for them to be at the front lines.
    Third is that sometimes Caribbean students can feel lost at sea in clinicals when we have no campus. We can only communicate with coordinators by phone and email, and it can be very difficult to schedule your rotations as you want.
    Clearly none of these things are problems at U.S. schools, but really other than these three, where does the superiority complex come from?

    • The writer makes a lot of assertions, some correct and others less so. But the bottom line:
      1) pass rates on Step 1 and Step Cs and Ck. If a person can’t pass these national boards, then there is little point in talking about good or bad. Schools in which there is a poor rate signify that something is wrong. Acceptance criteria or the curriculum.
      2) acceptance into residencies. This is more complex because some residencies worry less about the medical school and more about national boards Others put a premium on a holistic evaluation. Further, rotation sites are also important. Accredited sites are correlated with success in the step exams and getting into residencies. Although no criterion is important, pass rates on the first try trumps everything.
      3) there is widespread discrimination against Carib students, partially quality of student, quality of basic science education, quality of rotations, ignorance of residency directors, and the list goes on.

  34. Do you guys think there are enough medical schools in the U.S. to meet the demand of physicians?
    For pharmacy schools, I feel that new schools are popping up way too quickly. Pharmacy students “plan B” seems to be attending these newly opened schools w/ pre-candidate or no accreditation.

    • You definitely have to choose your school wisely and make sure they are a reputable and are certified. You don’t want to waste your time and money on a worthless education.

  35. I’m a staff physician recruiter for placement firm that specializes in MD’s. I can’t seem to get a clear answer on PR medical schools/residency programs. Although PR’s are US citizens, it does not appear that the medical programs are comparable to the US since 37 states will not license them without additional US training (such as a residency). As always, the top, high paying jobs in the U.S. go to people trainined at the top U.S. colleges/universities. This is within any field. In the medical field, where a doctor does his/or her training is very important in how well respected they are and how much they will be paid. It’s not about how ‘good’ the programs are it’s about how much weight it carries with employers. End of story.

  36. Spycegrl-
    I’m a bit in the dark about where PR medical schools reside. My impression from speaking to MDs who attended PR medical schools is that some of them are LCME accredited=US allopathic MD schools but the others are not. I believe there are 4 total on the island. Regardless, i believe these schools are rather difficult to get into if you are not a PR resident and not of american-hispanic ethnicity.

  37. @ Richard and Spycegirl. There is a little bit of dis-information about PR schools. ALL PuertoRican Schools are LCME accredited (I can tell you this because I was part of the Accreditation Student Comittee that represented my school The School of Medicine of the University of Puerto Rico is “state” funded. Therefore, because its purpose is to create physicians to stay in, students must have really strong ties with the Island.In addition, as high as 60% of the students that get in UPR school of Medicine come from the University of Puerto Rico with really high GPA’s and nice MCAT Scores. The other 30-40% come from really nice schools in the U.S. including Harvard, Tufts, Cornell, etc. These guys are not your typical “low scorers” but they take advantage of the fact that they have ties with PR and education is cheap (tuition — 12 000 per year) and competitive.
    Many people think this is the top school of the island and I agree. As far as residency programs, residents have to take their boards just as any other resident in the US and they DO practice in the US. Requisites may vary according to State which may need one year of service, etc. Maybe you have confused MD’s who go to Dominican Republic and Mexico (which have not taken their USMLE’s) who then come to PR and can’t practice in the U.S. unless they pass them.
    Note: There are many Puerto Rican students who could not enter any of the schools of Medicine in Puerto Rico and end up in Mexico or Dominican Republic due to low MCAT scores and/ or GPA.
    To my knowledge, Ponce of School of Medicine and UCC (not sure about SJB) accepts students from the United States.
    Bottom line –> Puerto Rican Medical Schools ARE LCME accredited = any U.S. School.
    –> Students match within their specialty of choice with a high rate and can practice in any part of the US (requisites may vary by state). License is equivalent.
    Please let me know if I can clarify any other misconceptions.

  38. An MD is an MD. When their lives are in danger, these patients dont give a crap where you graduated from. Sometimes it’s not what you know, but WHO you know that matters when it comes to residency.

  39. Hi all,
    I recently graduated from college in May with a B.S. in Biology and a minor in Spanish. I graduated Phi Beta Kappa with a 3.78 GPA. I worked in a colorectal cancer lab for 2 years, and did other cancer research in the summer. I also volunteered in a hospital and worked on campus at a health organization. I did not do very well on my MCAT, I took it twice and got in the low 20s each time. Needless to say I was absolutely devastated and even depressed. I want to be a doctor more than anything, and it really hurts me to see people who test well on the MCAT and get accepted to American medical schools, even though they don’t really want to be doctors. I honestly don’t want to keep re-taking the MCAT because it’s expensive, stressful, and time consuming. I opted to go to graduate school at one of the best universities in the world (in London) and get a masters degree in Physiology. I thought at least this way I am still getting an education, expanding my horizons as a person, and having some fun along the way.
    My question is: do you recommend applying at Caribbean Medical Schools or applying to PA schools in the US? I heard there are programs PAs can do to obtain an MD. I went to a seminar about the new medical school in St. Kitts (UMHS-SK) and it looked legit; they say their students get US residencies (only the first 2 years are in the Caribbean and the next year is done in Maine).
    What do you recommend? MD in the Caribbean or PA in the US? I think I would be happy either way, I just want a future at this point!
    Thank you for your time,

    • St. Matthew’s University in Grand Cayman….2yrs there and the rest stateside. My son and his wife are in their last few months of residency and had no problem getting signed on at a major medical center in a practice. My youngest son is now in his second year of med school at St. Matthews. People drop out left and right because you are not as “spoon fed” as you are in the statestide schools (if you get into one). Good luck to you!

    • There really is no comparison between MD and PA. The correct comparison is between Nurse Practitioner and PA. Both pathways are rigorous, require many of the same prereq courses, both have reasonable income (between 70 to 90 thousand dollars), reasonable amounts of autonomy and respect. The amount of education and training is a fraction of becoming a Board-Certified physician.

  40. Becca,
    Try applying to any of the well-established schools like Ross, SGU, AUC, SABA before thinking of attending any of the newer schools. You only spend a little over a year ( 16 months at Ross) outside the US with 2 week breaks every 3 months or so. For me and most of my friends, our island experiences was more pleasant than returning to the US and certainly better than surviving our residencies. You can also go the DO route but I would advice against applying to PA or NP schools because you’ll basically work as a resident for the rest of your life.

  41. Becca:
    If you really want to be a doctor, then why would you go to PA school. I would not recommend going to any of the newer offshore schools like the one you are mentioned. If you go Caribbean, only SGU, AUC, Ross, and Saba are fully recognized by the US Dept. of Education. I am sorry you’re MCAT has been such a hurdle for you. Caribbean schools will take you with a decent score and decent grades. You’re grades and everything else about your resume looks excellent so I think you’ll get accepted to any of the best Caribbean schools. You can apply for any semester starting not only in September, but also January, and sometimes May at most of these schools. Definitely look into that option.
    My friends who have been attending Caribbean schools, have had nothing but good things to say so far, and commented that living outside of the US for 1.5 years has been much more of a benefit than an inconvenience. I don’t understand why some people make such a big fuss about leaving the US. It might be one’s only chance to live in a foreign country and broaden one’s horizons.
    Again, if you want to be a physician and cannot secure admission to a US MD school, go to a Caribbean or other foreign four-year medical program. If you do well there, it will get you where you want to be.

  42. Oh, you also may want to look into DO schools as well if you like the philosophy and this alternative take on medicine.

  43. Thank you everyone. I appreciate your comments. I will look into the better known Caribbean medical schools.

    • Try St. Matthews University Med School in Grand Cayman. It’s very good and yes, they do require you take the MCAT. I have one son and his fiance who graduated from there and now in their third year residency after having absolutely no problem with getting rotations and residencies in excellent hospitals. They have offers coming from all over the place for them to practice. I also have another son who just completed his first year at St. Matthews and did very well….. it’s tough as they all are and trust me, you will never see the beach. People think that Caribbean students have it made because they are in the tropics. Those are thoughts of the ignorant. You won’t have time to play on the beach…….ever. Unless you stay there during a semester break when there are no classes in session.
      Good luck to you.

  44. Dan,
    The DO philosophy and alternative take on medicine is merely a historic difference. Allopathic medicine has adopted the osteopathic philosophy on patient-centered care and preventive medicine, and it is now impossible to tell the difference between DOs and MDs aside from the letters after their name.
    My belief is, if you want to stay in the US for all 4 years of med school, have all your clinical rotations at hospitals in the same area with no hassles about being approved, and have the option of obtaining a highly competitive residency like orthopedic surgery, neurosurgery, or dermatology without competing against 25000 MD candidates, you should go the DO route.

  45. Well, the frequently mentioned smaller competition among DOs for DO residencies does not hold true anymore due to the increasing DO class sizes and newly opened DO schools, while the number of DO residencies is not increasing. A lot of DOs actually apply to MD residencies, because there are much fewer DO residency slots relative to the number of DO graduates. They also have simply a lot more options when they apply to MD residency programs. In previous years, especially in the 80s and 90s, competition for DO residencies wasn’t as bad, but today DO schools are producing a lot more graduates leaving limited residency slots in more competitive specialties. That’s why the frequently presumed “advantage” of DOs for residencies is not really that accurate. The most competitive residencies simply go to the most qualified individuals. The “route” itself to one’s medical degree does not really give you an advantage or disadvantage.

  46. Surprised Saba was not mentioned in here. Although established later than AUC, Ross, and St. George’s, Saba maintains a first-time pass rate of 90%.

  47. That’s why I chose D.O. People need to open their eyes. In other countries, if you can’t get into medical school, you’re S.O.L. but here in America, we have a deeply rooted system of medical education called osteopathy. The only difference clinically from DO to MD is merely historical (and a letter). [However, D.O.s have to learn everything MD plus a few hundred more hours of OMM, which I believe only makes me a better doctor)
    I graduated with a tough degree Molecular Biology and Microbiology with a 3.8 GPA. Took the MCAT twice and both got a 24 (I just suck with these standardized testing – it was the same story with my SAT) Spent almost 5 grand in MCAT prep, primary and secondary fees, and plane and hotel fees for medical school interview. I will poke my eyes out before I go through the application process again.
    Reasons for me to choose D.O.
    1. Got accepted to arguably the best D.O. school – PCOM (which is older than a lot of MD schools)
    2. Will not waste another year of my life trying to apply (we only average 26700 days to live – 75 x 365)
    3. Tired of all the faking to make my application look good. (I don’t like research so stop telling me it’s so critical) Plus, All the officers in my preAMSA club were only in it to make their application look good – they could care less about the club.
    4. My mentor, best doctor in the world, Dr. Rampil is a D.O.
    5. Contrary to what some dumb premeds think (I was one), nobody outside the premed community cares about the letters D.0./M.D.
    6. Probably the absolute number one reason that I chose D.O. over Caribbean was that there was this ONE slacker cheating chick that was in my undergrad class. She cheated in everything and I absolutely hated it. Everybody knew it (she was even caught a few times but never got kicked out) and hated it too. But when it was time for applications she was rejected from every school, MD and DO programs (and she applied to a LOT of schools – over 30 total) [I love Karma] Anyways, she bragged to me one day that she got accepted to 3 medical schools. “Oh, Where?” I asked. She responded “Caribbean” schools.
    These are just my opinion on Caribbean schools and what made me choose what I chose. I’m neither right nor wrong.

  48. Hi
    This article was great and contained very valuable information. I almost gone through all replies and almost everyone named just four Carabbean universities AUC, Ross, St. George’s and Saba. I got accepted to the Medical University of the Americas and was wandering that does anybody have any information to share about this University. Is this an accredited one or why it’s tuition fee is almost half of the above universities which make me to think twice before accepting the offer. I really appreciate if somebody give me some information about this university.

    • It can be difficult to get information about a specific school. Many do not disclose basic information. Student blogs provide some correct and a lot of incorrect information. Realistically, the four schools are the only ones with an established track record. Most importantly, they are eligible for federal student loans. Finally, accreditation does matter. Many states won’t consider students who don’t have recognition from ACCM or other accrediting bodies.

  49. There’s been a lot of discussion of the Carrib vs. DO option, but I’m wondering about DO/Carrib vs. say, a top school in Germany. I have an undergraduate degree from the US and got into the 2nd year (out of 6) of a German med school. The GPA on my degree from the University of Chicago was low-ish (3.2) because I originally thought I was just going to graduate school so I thought I should take this opportunity. I came to Germany without realizing the potential disadvantages I’d have when applying for a residency back home. Does anyone know what kind of boat people from well-respected European med schools are in when applying to the US (as compared to Carrib.)? I plan to do my final year fo clinical rotations in the US. In germany the tuition is $1,500 pery year, but you have to learn German fluently. Will I be at enough of a disadvantage applying for desirable resdiencies in midrange competitive specialties (like EM) that I should consider reapplying for med school in the US, which would also take another 4 years?
    Not that there’s any universal right answer, but I’d really appreciate the perspective of someone in the know.

  50. I would like to respond to Dan’s post. Of course there are many European doctors in the US. My dermatologist at UChicago for example is from Greece and went to med school in Athens. Unfortunately you cannot simply apply and enroll in most European medical schools. Also, Germany’s medical schools are all 6-year programs, and I think so are all other regular medical programs in Europe. You have to be a citizen of one of the EU countries to be accepted, have graduated high school with IB (international baccalaureate), and of course be fluent in the language of instruction (German or whatever applicable for other countries).
    However, there are a couple of 4-year programs for US students in Ireland, Poland, Israel, and a few other countries. Everything there is in English, and is completely open to US-citizens. Check out – it lists all the US-modeled programs in Ireland.
    You must know though that grads from other foreign medical schools usually have a slight disadvantage compared to Caribbean grads, since Caribbean students do all of their clinicals in the US, and Caribbean schools have very well established connections to US hospitals through their partnerships. Also, many residency programs strongly recommend US clinical experience – some even require it.
    The bottom line is that the best choice is always a US MD school. Going to school in Europe might be a fantastic experience, but might also be a more risky choice when it comes to residencies. Going Caribbean (but only to one of the big three) would be a safe alternative, since they would give you the full US clinical experience, and prepare you virtually identically as in the US.
    Hope that helps.

  51. It is up to the individual… the arguments over DO/FMG/AMG are for the academically immature seeking the degree for the wrong reasons. If you want to be a physician I advise to stay away from message boards. The majority of the comments are written by amateur pre-med students, generally negative, and most of the time not at all accurate. Contact the hospitals/residency programs you are interested in and ask them directly what credentials are needed and meet those credentials. After all, they are holding the position you want so ask them what they need and discuss with them your plan!
    Hard work, networking, confidence and passion fill the holes in any medical program. Make connections early and DON’T listen to people who ARE NOT already where you want to be!
    I am currently completing three doctorates (DC MD PhD). I wouldn’t be able to if I listened to the negative feedback from people who couldn’t see themselves in the shoes I’m wearing today. Surround yourself with positive reinforcement, take small steps, and you’ll achieve what YOU want. In the end you will be treating patients while the others are still having the same old silly arguments.
    Whether you decide on DO, FMG, or AMG use the unique attributes of each, (whether it is holistic therapies, experiencing a different country, etc.) to your advantage. Regarding the stigma that the ignorant depicts… at the end of the game the king and pawn go back into the same box.
    So it is up to you… and I will tell you one thing for certain: You cannot be at the right place at the right time sitting at the computer.

  52. This is about Ben’s post. I admire your consideration to go to medical school in Europe, and wanting to take on this adventure. However, you must know that medical schools in Europe usually all have 6-year programs. Also, you will need to speak the language of instruction fluently, have an IB high school degree, and be a EU citizen in order to be considered.
    However, there are a few programs that are 4-year programs in Ireland and Poland I believe that are open to US citizens (tuition is much higher though than for EU citizens). Outside Europe, Israel and Australia have 4-year programs in partnership with US hospitals. Generally, those schools can be a very good option, especially if you want to experience a truly internationally oriented medical education.
    I could not agree more with “eviscerator.” You are absolutely right that the hype about which path is better becomes irrelevant once you are actually in med school. My suggestion is that it’s not worth waiting another four years in order to maybe then enroll in a US medical school, when you could already be a doctor at that point.

  53. Kevin, you do sound like a lot of DO students I know. Please do not keep reiterating that a DO equals an MD – this is simply not true, and maybe you then should have reapplied to MD programs in the first place. I hope you will not try to “defend” your degree your entire career, but rather embrace its differences. Sorry, but I am tired of DO students perpetuating the idea that they are the same as MDs. Their DO degree makes them different and unique within the medical field, and I always thought that’s why they chose it, or didn’t they?
    Also I would like to ask everyone here to please stick with the actual topic of discussion.

  54. Here’s an outline of my story:
    1) American born
    2) MCAT many years ago (took it one time): 29
    3) Graduated from UCLA: 3.5 GPA science and 3.6 overall
    4) Many years of experience as an EMT, cardio tech and BLS instructor
    5) Did not get in to any US med school
    6) Attended and graduated from AUC (St. Martin) and received MD
    7) Did clinical rotations (3rd year/4th year) California and Chicago, Ill
    8) USMLE scores Step 1: 216
    Step 2CK: 225
    Step 2CS: passed on the first try
    Step 3: 220
    9) Did residency (Internal Med) at USC (Southern California)
    10)Completed fellowship (Critical Care/Pulm)
    11) Doing well and happy with where I went and what I’ve accomplished and continuing to accomplish

    • Amy…..wonderful!!!! That’s great! Thank you for sharing some hard core facts!!! Finally…reality!!! 🙂 There are so many ignorant remarks coming from uninformed individuals here. You were a breath of fresh air!
      I wish you every happiness. You deserve it for having worked so hard for where you are in your profession. 🙂

  55. Amy is an example that there are many highly qualified students, who did not get into US MD programs. Also, her example shows that an FMG can get into excellent residency programs even WITHOUT a high USLME score (216 is only about average). Did you get your first choice Amy (both for residency and fellowship)?

    • My son and fiance got their first choices for residency. They attended St. Matthew’s in the Cayman Islands for med school. Went many places for rotations (Michigan, Florida, Chicago, and even Manchester , England and got their frist choice when it came to residency…. at St. Francis Medical Center/MethodistHospital in Peoria, IL.

  56. Hello,
    I think if everyone’s ultimate goal is to practice medicine and treat patients, which it should be if you want to be doctor, what comes after your name shouldn’t be such an issue.
    To be quite honest, a patient is not really going to care what you got on your MCAT or if you are DO or went to the Caribbean just how well you treat them when they need you.
    No one can deny, that there are amazing doctors that are DO’s, Caribbean graduate MD’s and MD’s from the states just like there are not so great doctors from these same categories. It comes down to the individual and how they take their education, skills and experience to be the best doctor they can be.
    Instead of arguing about who is better everyone should recognize that each brings something different to the field of medicine and all should be given equal amount of respect and value.
    Just my two cents!

  57. Thanks for your replies. I guess I hadn’t made it clear in my post, but I actually have already enrolled in a German university and I already have a BA degree. I was able to do the first two years in one year, so it will total 5 years until I’m done. I figure that’s extra time I can research or study for USMLEs. I already learned fluent German, so that’s taken care of.
    Also, I just want to note that you can get in to Germany through 3 avenues: IB degree, 5 AP exams + HS diploma, or BA degree. You definitely do not need EU citizenship. I have the BA degree, which admittedly sets me back a bit, but I’m not much older than the average German here. I will be able to spend my final year getting USCE rotations in the US. I don’t know how hard it is to get those rotation spots. All of this, plus the fact that I’ve taken off a few years here and there means I’ll be older – 31 – when I start my residency. However, I won’t have much debt (~50k) because of the low tuition (1-2k per year) and the fact that you can work on the side. That’s about 3-4 years above the average age in the US, I guess.
    All in all, I think it is a workable path, but it is definitely challenging and more difficult than just going for the right GPA in college and getting in (couldashouldawoulda). I’ll have to do as well as possible on the boards and apply broadly with little discretion and probably forsake the most competitive specialties. If I play my cards right during my final year of rotations I might be able to score a specific residency through a direct contact.
    So EU schools are an option because some will allow you to spend 1 year doing rotations in the US if you organize them yourself.
    Sometimes I think I could have improved my 3.2 GPA from UChicago and my 3 publications and actually gotten in somewhere in the US, but it’s a moot point: My girlfriend was living in Berlin so that really sealed it. What I wanted to know is whether one can have a decent shot coming from Europe and it sounds from ya’ll like it’s reasonably possible.
    If it was a really, really hard path I’d consider shifting course and applying in the US. But like eviscerator said: “Hard work, networking, confidence and passion fill the holes in any medical program.” I hope I’ve got what it takes.
    Still, thanks for the comments. The Caveat to all this is that if you do have the ability to get into a US med school (I don’t know that I do) and go to Europe you’re probably giving up the ability to choose your top 1-10 residency picks.

  58. Ben – I think you made a great decision. German medical schools are among the best in the world, and certainly on par with the top US schools. Just keep up with all the English medical vocab, which you’ll need for the USMLE.
    You can certainly any residency you want if you do well. My dermatologist at UChicago hospital is from Greece and she went to medical school in Athens. Having gone to medical school in Europe will broaden your horizons and will make you an interesting candidate. Plus you will get an excellent education for a minuscule tuition – sound good to me.

  59. No one is talking about the living condition in caribbean..
    is it that nice? is it tough?
    I am actually an international student who goes to school in U.S..
    with GPA 3.85 accum, GPA 3.88 science. and…MCAT
    I will be applying both Caribbean and DO.
    I saw a post saying how AUC has the best quality living among caribbeans.
    Is that true? anyone from SGU? or Saba,ross?
    And i heard many people who went to caribbean med schools had to wait another year or two to get into a residency…is it typical with SGU, AUC, Ross, or Saba? or is it only the case if a person goes to other caribbean schools other than those listed.
    I guess my biggest concern is the weather condition in caribbean.!

    • It is HOT HOT HOT! And humid. And there is hurricane season. The students apparently are always taken care of in the way of evacuation immediately and have never heard of anything bad happening.. so I wouldn’t worry about that. Just make sure you get a place with air conditioning.
      St. Matthews in Grand Cayman has two decent dorms if that’s what your interested in. It’s a good idea to do that for the first semester so you can meet others and possibly form some study groups and which is what my son’s did. They found other housing when they became familiar with their surroundings and also made some close friendships with whom to share housing with in the way of an apartment.
      My son’s found other rental apartments near the school with pools that are wonderful and very comofortable…..more so than the dorms which naturally aren’t as nice.
      My son’s went to St. Matthews in Grand Cayman and the one who is now in his last year of residency never had to wait to start his residency.
      I heard that Granada isn’t such a great place as far as living. I have no proof other than what my son’s friend who went there, said.
      Advice would be to make sure your living arrangements are comfortable and pleasing to you becasue that is where you’ll spend all your time…….studying.

  60. I would like to clarify a slight misstatement of Dr. Freedman’s in her otherwise excellent article. She wrote, “In the US, Caribbean schools must be accredited by The National Committee on Foreign Medical Education and Accreditation of the US Department of Education and by some individual states.”
    Actually the National Committee on Foreign Medical Education and Accreditation (NCFMEA) does not accredit Caribbean or any other type of off-shore medical schools. But rather, (from their website):
    “The NCFMEA only reviews the standards that a foreign country uses to accredit its medical schools. The request by a foreign country for review by the NCFMEA is voluntary.”
    While she is correct that NCFMEA provides a comparison of accreditation standards, the significance of NCFMEA approval is explained in their FAQ section:
    “Why is this type of comparability determination important?
    It’s important to American students who want to attend a foreign medical school and wish to receive loans under the Federal Family Educational Loan (FFEL) to help them with educational expenses. If the NCFMEA determines that a foreign country’s accreditation standards for medical schools are comparable, then any accredited medical school in that country is eligible to apply to the U.S. Department of Education to participate in the FFEL Program.”
    What Dr. Freedman has most likely done is confuse NCFMEA with ECFMG: the Educational Commission for Foreign Medical Graduates. An ECFMG listing through its International Medical Education Directory – Foundation for Advancement of International Medical Education and Research (IMED-FAIMER) is the minimum standard of approval or accreditation required by the US Department of Education for students and graduates of medical schools outside the US or Canada. IMED-FAIMER listing endows students or graduates with eligibility to take the USMLEs and gain ECFMG Certification.
    This may seem an insignificant distinction. But I think worth noting for those students who may not gain admission to a US medical school.
    -Side note to the Quality of Medical Education paragraph: this van Zanten and Boulet study was completed in 2007 hence giving an incomplete impression of Step 1 results to the present day. In particular results from nations with multiple medical schools (Dominica, St. Kitts & Nevis, Antigua & Barbuda…etc) will not accurately reflect each individual medical school nor the quality of their educational system. I suggest contacting the individual schools or ECFMG for more specific information.
    Tipton Carlson

  61. Dear Mr. Carlson,
    Thank you very much for the clarification regarding the NCFMEA. This was originally brought to my attention by Marta van Zanten and the article was modified prior to your comment submission. The article is now accurate.
    Jessica Freedman, MD

  62. Hey DS,
    you asked about the living conditions on some of the Caribbean islands where those medical schools are located. I have heard too that AUC (St. Maarten) is a very developed island (it’s a major tourism hub and has the second busiest airport in the Caribbean). Living conditions on St. Maarten are comparable to the US and Europe. The island is half Dutch, half French, and good food is abundantly available. Other islands are a lot simpler (Grenada, Saba, Dominica) but it might be a great experience to live in an environment different from that in the US – also living is cheaper there.
    I don’t know about that one year before residency, and I think it should only affect those that did not match, which is very few from AUC and SGU.
    With your other concern about the climate, I don’t think you have anything to worry about. I have been to the Caribbean and the weather is very pleasant. Temperatures throughout the year only fluctuate very little (from about 70 to 85 degrees). Summer temperatures are actually cooler than in Florida. Hurricanes sometimes strike the area though, as the Caribbean is in a tropical climate zone. This might be something an international student might have to get used to. I don’t know what country you’re from, but if you are from a country like Sweden, Germany, or Russia and go to school in the northern US, it might take you a while to get used to the climate 🙂

  63. well, i am actually considering going to ROSS Medical School, i just need the proper guidance into getting there.

  64. Don’t limit yourself to just one school though and look into others as well. Ross has huge classes and even needs to weed out a lot of people in the first semester.

  65. Having attended/graduated from ross medical school and now working/teaching as an ED attending MD in the NE (not NY), this medical school does not weed out students on purpose. The attrition rate is due to lower admission criteria ( GPA 3.2-3.6, MCAT- mid to high 20s), which is meant to equalize the quality of Ross graduating MDs vs. the allopathic MDs. Immaturity, family, financial, etc. are other reasons. Purposely ‘weeding out’ people=less money for the school in the long run=bad for business. And no, I do not work for the school.

  66. Miles, i appreciate your information. Thanks alot.
    Last question.
    is it right to say:
    1.) in terms of primary care: both D.O. and Caribbean M.D. should not have hard time getting into a residency?
    2.) if not going for primary care: both D.O. and Caribbean M.D. will have less chance getting into a residency compared to US MD.(this one is rather logical and obvious)
    3.) If not going for primary care: D.O. has slightly better chance, because they are in US. and they have their own residency programs?
    From what i have read, 0.1~0.5% of caribbean MD goes to non primary care residency.
    Thanks again miles.
    oh by the way: right now i am not sure what i want to practice and I think it will change anyway once i get to the medical school somewhere someday.

    • FYI…..residencies in specialties are tough to get into no matter what med school you go to. Some go into Family Medicaine then switch . I heard it’s easier to switch into a specialty than apply for a speialty from the start. ??? I have no idea. Just sharing what I heard. 🙂

  67. Kevin (& David)- I too have two friends who were just accepted into Ross University with extremely low MCAT scores, or shall I say considered unacceptable to the US ( they were 18 & 20 to be precise). I also have a cousin who was accepted without taking an MCAT at all. To me the numbers just speak for them self, no explanation necessary.

  68. Wow Cory, you seem to know a lot of underachieving people/relatives, who all happened to go to Ross. If they really that “unacceptable” then they won’t stay in med school very long.
    DS – you’re welcome. I would recommend doing some more research about different schools on your own and then decide which path to go. DO NOT listen to people in this forum (including me). Most people ranting in here have no idea what they are talking about. As I said, don’t trust me on this, but here is what I am pretty certain about:
    1. Primary care residencies are the easiest to obtain (especially family practice) and the average med student shouldn’t have a problem securing one.
    2. DOs and FMGs generally have a smaller chance getting a particular residency when they are competing with a US MD with the same qualifications. This slight disadvantage, however, can be compensated with board scores, LORs, etc…
    3. I wouldn’t say that DOs or Caribbean MDs have a better chance matching into allopathic residencies, but DOs have the option of osteopathic residencies as well. However, spaces in DO residencies are limited as well, and new DO schools seem to open every year –> higher competition
    4. I have no idea from where you are getting the 0.1-0.5% non-primary care statistics. Where exactly did you get that kind of false information? The real number is more like 50%.
    Do you want to go into primary care? If current trends continue there won’t be nearly enough primary care physicians in the US, and there already is a shortage.
    Also, you will need to make sure that your home country recognizes the school and the degree (not every country recognized the DO degree) in case you will return home in the future. Have you considered going to med school in your home country at all? This might be a lot cheaper, especially since you cannot get financial aid as an international student.
    Hope this helps.

  69. Wow thanks Miles..
    well about the information on the non-primary care residency,
    I got it from
    “relaxedMD” said it
    Dermatology: Nearly Impossible?
    0 (zero) of 1664 matched US IMGs entered Dermatology in the US
    4 of 3272 matched FMGs entered Dermatology in the US
    Assuming that no one is admitted to Derm residency outside of the match, that means there are zero 2008 matched US IMGs in Derm.
    Orthopaedic Surgery: Nearly Impossible?
    6 of 1664 matched US IMGs entered Ortho Surg in the US
    13 of 3272 matched FMGs entered Ortho Surg in the US
    Assuming that no one is admitted to Ortho Surg residency outside of the match, that means only 0.36% of 2008 matched US IMGs entered Ortho Surg.
    ENT: Nearly Impossible?
    0 of 1664 matched US IMGs entered ENT in the US
    5 of 3272 matched FMGs entered ENT in the US
    Assuming that no one is admitted to ENT residency outside of the match, that means there are zero 2008 matched US IMGs in ENT.
    Diagnostic Radiology: Rare yet Possible!
    30 of 1664 matched US IMGs entered Diag Rads in the US
    44 of 3272 matched FMGs entered Diag Rads in the US
    There were 22 unfilled spots in Diag Rads in 2008. Assuming that no one is admitted to Diag Rads residency outside of the match, this simply means only 1.8% of 2008 matched US IMGs entered Diagnostic Rads.
    Anesthesiology: Rare yet Possible!
    56 of 1664 matched US IMGs entered Anesthesiology in the US
    60 of 3272 matched FMGs entered Anesthesiology in the US
    There were 36 unfilled spots in Anesthesiology in 2008. Assuming that no one is admitted to Anesthesiology residency outside of the match, this simply means only 3.4% of 2008 matched US IMGs entered Anesthesiology in the US.
    The numbers are just as I guessed earlier, extremely low. Remember that those are the proportion of matched candidates from the US IMG pool. The actual number of people that took their chances in the NRMP Match in 2008 is nearly twice that (Active Match Applicants 2,969), making one’s chances even lower. Put it in perspective with Anesth: 56 of 2969 applicants were successful in acquiring Anesthesiology residency through the match. Your chances are 1.9%.
    Unless you are among the top 5 in your carib class, and can achieve 97-99 on step 1 and step 2, please be realistic with your chances of achieving competitive residencies from the caribbean schools, including the BIG 4. It is a tough journey.
    You are actually right on the option of going back to my home country.
    It will be cheaper.Yet…I have to serve in the army for 2 years.. and If i go back i have to catch up with my native langauge. I have been in U.S. since 8th grade..I would rather wait a year to retake the MCAT..instead of spending about 3 years in my country trying to go to med school. But I dont think I will improve much on my MCAT, so i am considering D.O. and Caribbean.
    I appreciate the thought though…
    by the way….are you a med student?a graduate???

  70. Cory, kevin, other DO supporters:
    That is so interesting. I too know 3 friends who got into DO schools with MCATs in the 18s-22s. I also know relatives who went to PCOM/NYCOM even without MCATS. I think some of there were under probation too. I agree with you, these numbers speak for themselves.

  71. I have two questions if someone can please help me
    1) Does anyone know a website where it list which Caribbean schools are accredited by the US?
    2) for the Caribbean schools that do not require the MCAT (i.e. AUA and Saba), can they still be US accredited?
    thank you

  72. Well, a lot are accredited, but only four are FULLY accredited, which makes their graduates eligible to practice in all 50 states and Canada (those are AUC, SGU, Ross, and Saba). I would not recommend looking into any other offshore schools but those four. AUC and SGU are probably the best on the list, and also have higher admission standards.

  73. Here my resume, I was wondering if I have a chance of getting into 1 of the big 4 caribbean schools:
    1) gpa 3.14 overall (science is 3.0)
    2) MCAT in the mid-teens :-/
    3) BA in Math
    4) Over 300 volunteering hours at a hostpial
    5) Im current doing research
    6) I went to a big name college (U of Mich)

  74. Mike N., I’d say that you will need to retake your MCAT – the average scores for AUC and SGU are between 25 and 26. Your GPA is not that high, but you did attend an excellent and challenging college, and you might not have focused as much on the natural sciences while finishing your Math major. Keep doing your research job, take some more time to study for the MCAT, and then take it again when you feel ready. If you get a score of above 20, you can give it a shot. Keep in mind that Caribbean schools give you the option to apply for either the fall, winter, or summer semester. Starting in the winter (Jan) or summer (May) might be a bit easier to get in I think. I think it would be possible for you to apply for the winter semester (starting in January) if you get your scores up until then.

  75. Sorry one last quesiton. Saba does not require the MCAT, just recommends it. When I apply there, won’t it best if i dont submit my MCAT score?

  76. I am surprised to hear that Saba does not require the MCAT. Well, if you really do not want to take it again, and therefore not apply to any of the other three, go ahead and apply to Saba. And no, you should not submit your MCAT It is so low that it would definitely hurt you.

  77. Hi everyone,
    I’m a bio-chem major entering my senior at Manchester College (IN). I spent a month in Nicaragua on a medical practicum last year assisting a team of doctors. On the trip I found that I am most passionate about practicing outside of the United States, in places like Nicaragua, where I feel they have the greatest need for doctors. However, I’m afraid that in doing so I would make it impossible to pay for med-school debt. Do you have any advice??

  78. Only last year did I apply to over 30 allopathic anesthesia residencies, received over 20 invites, and attended 11. There were some well known (OHSU, Univ. of Washington, Mayo Clinic, Washington University), and some not so well known programs in that bunch. I am a DO and I went through the allopathic match for an anesthesia residency position. As we all know, anesthesia is becoming one of the more popular specialties (not at the level of derm, optho, etc.) but it was not uncommon for me to hear that programs had over 700 applications for their spots. The one common theme…three of the more influential programs that I applied to stated that there was no way they would take FMG over a DO or MD. This was straight from program directors mouths. They said they wouldn’t even interview the vast majority of them regardless of their board scores. Yes, it depends on the specialty but I only met one or two FMG’s on the interview trail last year but quite a few more DO’s. I am not bashing FMG’s, but there is no way I would go through Ross or any of the other programs unless I was doing a primary care residency….it’s as simple as that. That’s not to say there aren’t FMG’s that get into optho, or derm (as I am sure some of you will immediately point out), but if going purely by the numbers…DO or MD all the way.

  79. Craig,
    I am sure there are programs that hold the same bias against DOs as there are programs that hold biases against FMGs. Presumably the fact that you are an osteopath makes you biased against medical doctors educated outside the US. I have never heard that kind of prejudice against FMGs from MDs as I keep hearing from DOs. What in the world is the deal with that? Also, what I don’t get about you DO people is that if the tenants of osteopathic medicine is supposed to focus on PRIMARY CARE, then why do all DOs here on this board keep talking about the so-called “competitive” residencies. You all seem to ignore the fact that osteopathic schools are the schools that are supposed to provide the country with family doctors.
    Which residency program have you decided to attend by the way?

  80. Does anyone know of Antigua Medical School?????…its linked with Manipal medical school in India. Please let me know what you think of it.

  81. I am doing anesthesiology. I was going to do internal medicine but changed my mind in third year. To think that everyone that goes to a DO school will do primary care is short-sited. How many people go into medical school knowing what they want to do in life? All of us right? The question is is how many of us change during the course of our medical education. A lot of us. MD or DO I would have ended up anesthesia. DO programs work to get people into the primary care field a lot and they succeed a lot, but not all the time. Not everyone that goes to a DO program wants to be a primary care physician at all. I have nothing against FMG’s at all. I know a couple that are great people, probably will be great doctors. I am sharing what I was told point-blank by several program directors in anesthesia only. I am sure at those same institutions that there are program directors in other fields that are anti-DO but I didn’t get that feeling. Just letting you know what was told to me directly on my interview trail for a fairly competative specialty.

  82. DO’s and MD’s are different, very different, but there is no way I would go to a carribean medical school. Good luck man, your going to need it to get back on shore once you head out across the sea. You have no clue as a Junior in college, you’ll find out shortly.

  83. No hostility, just providing my insight into what I was told in person at several programs in anesthesia only. Yes, I have several friends that graduated from these programs (in all stages of residency training). I don’t know who this Kevin is that you speak of. No, I will not tell you the programs and I don’t really see any need to explain why. If you think I am lying, so be it. If you called the program director do you think he/she would say that they said those things really? Come on. Did I got to a carribean medical school…no. My experience comes from what programs have told me and what my FMG friends have told me…that’s it. Just relating personal experience is all. Would be like me listening to a Junior in college about my DO program…wouldn’t make much sense. I don’t have an attitude against FMG’s by the way, again I have friends who are FMG’s. Doesn’t change the fact that them getting into a residency is tough. Don’t listen to what I say, I don’t care one bit. You should be looking into this yourself. As I said before, just passing along information that was given to me at my interviews. Good luck with the future.

  84. Oh, and I am not defending my degree. I have no reservations about my program, medical eduation, degree, and future area of expertise. I am confident in my skills as a physician and at the same time realize I have a lot to learn. I will never regret being a DO.

  85. BEN,
    how did you get the Physikum (the first two years of German Med School) in one year?
    I would like to know. Is it at all possible?
    Thanks for the info

  86. Again, I assume that your FMG friends are probably from non-western medical schools. Those would actually be called IMG (international med…), since they are not US citizens. I wish the US would produce more doctors so there would be no need to fill the slots with doctors from Asia and other places. Trust me, I have personally seen many really bad doctors from those places, and have no idea how they got a US residency. However, there is nothing wrong with Americans going abroad to receive their medical education at a good foreign school, as well as to offer competitive residency slots to good foreign physicians from Europe, Australia etc.

  87. Well, I think Kevin’s and some others’ resentment and negativity stems from their constant attempts to establish a hierarchy, in which they want to place foreign-educated physicians below docs from US medical and osteopathy schools. To me this seems like trying to compensate for a subconscious inferiority complex they have because of their DO degree, a degree which is legit and perfectly fine, but makes them different from the vast majority of other doctors. Have you noticed that all of the negative statements in this forum have come from DO-proponents (Kevin, Craig, etc.). Why don’t they just leave FMGs alone instead of talking them down.
    The last comment was absolutely right and echos exactly what I think – it’s the individual and not the medical school that gets one a residency and a successful career. There really is no need to further discuss this point of the story. I think it is fairly accurate to say that the education at the good Carib schools (AUC, SGU) is mostly on par with US schools, and the feedback from student in those schools seems to be overwhelmingly positive. Therefore, if you want real information about these schools, then talk to students, who actually attend them/graduated from them and take what’s claimed by people trying to discredit them with a grain of salt.

  88. I don’t know a lot about caribean medical schools, but since there is now more US medical schools in the past several years and they didn’t really increase resident number I’d be wondering if in the next few years there was a decrease in people in the Caribbean and DO schools matching. I would not hesitate to tell my friends who did not get into an MD school in the US before to try these options, but I’ve heard that starting this passed years it would be harder to match.

  89. I meant this past years. I was typing and not paying attention. I’m just wondering if anyone thought about looking at what may happen in the future. This year was a harder match due to less spots per medical student and I’d be wondering how it would hit these Caribbean schools in the next couple years.

  90. It will hit the Caribbean students and other FMGs, who did not do so well (low board scores etc.). The ones that did ok should be fine. It really makes no sense though to increase the number of medical school graduates while not increasing the number of residency positions – this results in the exact same number of doctors, and all it does is making it harder for students to match.

  91. Steve, they have been saying that for years yet the number of residents fron foreign medical schools have not really decreased. If at all they have increased over the yearsm

  92. And it goes without saying that FMGs who did not do so well in their USMLE’s would have a hard time getting into residency. It is hard as it is to get into a residency program if you have low scores even if you are US educated.

  93. all of this depends on the specialty you choose to practice. those seeking to practice primary care may not have a problem getting into a residency program and subsequently finding a good practice opportunity. Specialists and surgeons on the other hand… forget about it.

  94. Sorry Bridget, I did not see that you were replying to Philip’s post, who did mention that it will affect people with low credentials (both FMGs and AMGs). Considering that there are primary care positions that remain unfilled every year, you are correct that these graduates will probably still match in spite of their bad scores.

  95. Hi, does anyone know something about American Global University??? I am planning to transfer, but I can’t find any info about it.

  96. I attended a US school with a strong reputation and in our third and fourth years, we rotated through several hospitals. While the majority of our rotations were hosted by top tier medical centers, we seemed to spend a week or two of every major clerkship rotating through a community hospital where the work ethic and physician patient interactions were often disturbing. Some of the medicine being practiced was questionable at best. This is not a generalization about community hospitals – these were our shared observations about a few particular hospitals. Many of my classmates took these rotations less seriously, and the evaluations we received from these hospitals were not given the same amount of weight as evaluations received from one of the ivory towers. At these community hospitals, we often worked along side students from Caribbean schools. Unfortunately, these students completed the majority (if not all) of their required clerkships at these hospitals!!!… and furthermore, !!!. They were under the impression; however, that they were receiving the same clinical training as students from my school. These students spend a fortune on their educations, must travel far from home, and encounter difficulties matching at decent hospitals when they return to the states. Maybe the situation is improving, but before applying for Caribbean medical school admission, I would retake the MCAT, take some more science courses, work at a hospital for a little while and then reapply to US schools. Graduating from a US school will make your life so much easier a few years down the line and will possibly provide you with stronger role models and clinical experiences. If you’re going into medicine for reasons of intellectual and emotional fulfillment, then there is absolutely no rush to start your training. If you want to be a doctor to make some cash (for as long as that will last) then you should consider that matching into the more lucrative specialties is even challenging for graduates of the top US schools. I have nothing negative to say about any of the Caribbean schools, but be certain that you are going to receive the education they promise and consider re-applying to US schools if that is an option.

  97. I appreciate your warning, and I absolutely believe you – yes, the majority of Caribbean schools don’t have the best hospitals for their clinical rotations, and do not provide an adequate education. There are SO many schools out there hurting the reputation of all offshore schools, even the good ones. A few Caribbean schools do provide a more or less equivalent education to US schools, particularly St. George’s and AUC. Both schools have affiliations with strong teaching hospitals. AUC’s Providence Hospital (Michigan) is listed in the Top 50 US Hospitals, and its new clinical site in NYC is also a teaching hospital of SUNY-Stony Brook med school. At Union Memorial, Maryland, their students rotate in a teaching hospital of Johns Hopkins and Univ. of Maryland. And SGU is affiliated to medical centers of the same caliber. So again, it really depends whether you’re talking about Caribbean schools in general or only the (two to three) good ones.
    Thanks for raising an important point though. The key here is not to generalize, and understand that the quality differences among offshore schools are vast.

  98. Oh, concerning Ursula’s question: I have never heard of American Global University, and I would recommend to be very careful. Why are you looking at that school? It’s probably not even worth looking into.

  99. Philip,
    If you have prior coursework you might be able to skip a year before the physikum if you’re very convincing and you happen to be able to put your schedule together just right. Definitely don’t count on it. I ended up finishing all my class work in one year, but I’m taking the physikum later anyway because I had no time to prepare for it.

  100. Thanks Ben,
    Have things changed in Germany regarding the language exams? Someone in the forum keeps saying that it has become stringent. Personally, his statements are outrageously exaggerated. And there’s a debate whether foreign nationals have to go through ZVS rather than applying directly to a university.
    I have a choice of med school in Germany or the Caribbean. It’s six years in Germany plus a year or two of learning German versus four years in the Caribbean. The Caribbean though makes for the better choice if one is to consider practice in the US.

  101. Philip,
    They may have been saying this for years but there were significantly fewer openings to scramble into this year in specialties that typically aren’t difficult to scramble in or match in ie ob.gyn. I heard this past year was the first year some of these newer schools had a graduating class and that there will be several more in the next couple years. My medical school is increasing the size by 10 to help address the predicted doctor shortage. These kids will be graduating in 4 more years. Other schools are increasing sizes + more schools and the same number of residency spots makes me think that in the next couple of years I’d be increasingly skeptical of going to a foreign school. At least DO schools have their own residency programs so they would not have to worry about this problem.

  102. Actually, DO residency positions won’t increase as well, and as new DO schools are opening up, there will be the same problem. I can’t believe this argument (more graduates = bad for FMGs) is being dug out again). Doesn’t anyone read some of the previous posts? This topic has been discussed to exhaustion, and the bottom line is that FMGs will be fine as long as they perform well on their boards, clinicals, etc. There is absolutely no reason to discuss this any further.

  103. Ok, i am getting sick and tired of this med school application process, i just sent out 7 apps to seven different US med schools and 3 apps to AUC, ST.GEORGES AND ROSS, i immediately got an interview with all Caribbean schools but i am just getting responses from US med school to fill out another freaking set of secondary apps that will cost some more freaking cash (i wonder if this will be part of the tuition), so my interviews for te caribbean schools are next month, my GPA and MCAT is not as competitive for the US schools, so what do every one think i should do? go ahead with the Caribbean and say F the US schools? or try to take the MCAT that got me sick of life the first time i took and and spend some more thousands of dollars to re-take courses to improve my GPA?, FYI i am broke! and 25 years old. I am really not planning to spend all my life practice practising in the US, i want to practice in Africa but i need the US experience stuff.

  104. I really enjoyed the article and the feedback everyone have contributed. Some of them were really touching because I believe that you must have a passion for what you do, reguarless of the pay check or MD status. Thanks to those of you that have given positive feedback. I say this beacuse I have been putting off taking the MCAT for sometime,based on what I have heard from inividuals that have taken the test. Its GPA this, MCAT score that. What about PASSION? I will love to be a Doctor/Physician its just taking me sometime to get there. I wish all you MD’s and DO’s all the best…….

  105. Kevin
    This might be outdated, but just wanted to respond to some of your points. A foreign MD, no matter where from, as long as they are licensed is “by law” equivalent to an AMG MD. Also, the excuse that DO students don’t report their USMLE scores is false. Once they take it, they don’t have a choice to report it or not, it is automatically counted towards the average that is reported. The fact is, SGU/AUC/Ross has better pass rates than DO schools in general period. This says a lot about the quality of students of DO schools vs MD schools, since the pass rate is so much lower, and no, its not because DO schools don’t teach towards the USMLE, because they do. and no, its not because DO students worry more about the COMLEX, because they don’t. Most DO students take the USMLE first, and then study an additional 2 wks or so to take the COMLEX.
    As of right now (although it is very dynamic and can change from yr to yr), SGU matches at a higher rate than DO schools in general, according to SGU, on this email they sent to their students, (74.5 vs 69.9% for DO schools)
    Yes.. DO schools have their own residencies that is not factored in, and SGU (being a foreign school) is eligible for prematches, which is not factored into that 74.5% as well, so its kind of a wash.
    In reality, most DO students try to obtain a MD residency, because it is well known DO residencies are below par.

  106. I think many of the problems that people have with DO and FMG schools is not that you went there. There are many talented and smart people who went this route. And they are now excellent physicians. But on a whole the people I know that went to DO and Carribean schools went because they couldn’t get into allopathic medical schools.
    Own up to it already…

  107. Caution
    In reply to your post, the hospitals that SGU rotates through are green book rotations. Meaning there are residents actually being trained there as well. If your post is correct, which I’m not questioning, it is also true that these residents are not getting good training.

  108. CmonNow.
    I will own up to it. As a mother to be, working full time, taking a full course load and managing an $1800 hundred a month mortgage. I didn’t have the time needed to study for the mcat, like some of my peers. Sure, I could walk away from my husband and all the responsibilities I have, drop 2 g’s on a prep course, screw my benefits paying job, and get that 30+ score I need to get into my one state MD school (I live in a state with one MD school and two DO schools) – Yeah right. Instead, I’ll go to my local DO school school with my 3.97 gpa, and my mediocre mcat score. Once I matriculate, I’ll quit my job thereby giving me an extra 40 hours to study – ace the usmle – and take that bittersweet residency from someone with your exact mentality.

  109. I like this article. Recently i joined in Xavier University School of medicine, Bonaire. I consider this as one of the best Caribbean medical school in teaching and it is cost effective. i paid just 6k for the semester.

  110. It’s unfortunate that the article focuses on the most commercialized foreign option for US citizens who want to become IMGs. Carribean schools, above all else, are moneymaking machines: They do not serve a community of patients, and their only focus is the bottom line. To that end, they often employ instructors from English-speaking third world countries, they are located on islands with very low real estate and labor cost, and yet their tuition, housing, food services cost is more like out of state US tuition.
    An important fact that was omitted is that an IMG is always an IMG. The Carribean doesn’t enjoy a special licensure status, and its graduates have the same legal status in the US as the graduates of recognised medical school in Mongolia or Papua New Guinea. Which brings up an important issue: Why on earth would Americans consider the Carribean as their “best” foreign option? I won’t recommend a particular country. I found Cebu, Philippines to be a great place to study in English, and feel I’m getting my money’s worth from a school that’s recognised in all 50 US states, and charges less than $3000 per year. But for those who lack in premedical subjects, who haven’t done well in their undergraduate a 6 year program in China, India, Europe might be better suited. Latin America has some great medical programs too, if you speak Spanish. The English-language program at UAG, Mexico is just as overpriced as their carribean counterparts, and will take you 5 years to complete. But UNIBE in DR is a 4 year program that’s accepted in all US states except california.
    My point is that there is a whole world out there. Make educated choices. If you really like a particular Carribean school and you feel it’s worth the high price tag – do it! But don’t be scared into attending one because you think that a graduate from a foreign school outside of the Carribean can’t pass the USMLE, or can’t match for Residency. We have doctors from all over the world practicing in the US. They all passed. They all matched. And most didn’t have to go broke on Gilligan’s Island to do it.
    Just my 2 centavos.

  111. Sam
    A huge advantage of caribbean schools like SGU is that you do clinicals in the US in 3rd and 4th year. Other “true” foreign med schools will not. This is a HUGE advantage, as a lot of programs like you to have US clinical exposure. In addition, schools like SGU is based on a US curicullum and teaches towards the USMLE, whereas true foreign schools do not. These 2 advantages are enough to say that caribbean schools like SGU, Ross, AUC, are better options for foreign than true foreign schools if your primary purpose is to come back to the US. You are correct that caribbean schools do not enjoy special licensure status, but the transition to licensure is definately much more smoother from caribean schools who are 50 state recognized. Attending SGU, you do not have to prove equivalence to the medical boards in any of the 50 states. It has been already established, whereas true foreign medical schools you do, and its just a hassle, and not a guarantee. Although phillipine medical schools are great, going there, and ultimately trying to come back to the US will cause a lot of headaches compared to an established caribbean schools. In regards to profs at SGU, many of them are visiting professors from Canada, US and UK schools. For ex: Cardio section in path was taught by a practicing physician in the US, General pathology section was taught by a practicing pathologist in Canada. A portion of behavioral science was taught by practicing psychiatrist from Canada… the list goes on and on. Many phillipine med schools require you to finish your full 4 yrs there, before allowing you to take the USMLE. So you take step 1, step 2 after you graduate. HUGE disadvantage. To top it off, phillipine med school has NO US affiliations for rotations.
    Xavier is not considered one of the good caribbean schools this article speaks of. You might pay just $6k per semester, but you will pay for it, by having a really hard time getting a good residency, in addition, to the huge amount of hassles you will have in obtaining licensure once you have finished residency. It is better to attend schools that are 50 state approved (SGU, AUC, Ross, and maybe SABA (case by case in some states))

  112. Hey.
    Caribbean Medical school is awesome! The education quality is the same. If you’re going to waste the best years of your life in the library, you might as well enjoy the scenery on the walk there! lol
    Good Luck

  113. I went to UNE (Noreste) in Mexico in the early eighties. There is a LOT of anti Americanism down there, you have no civil rights no landlord tenant rights and most important no academic rights. Groucho got it right that he wouldn’t “join any club that would have ME as a member!” In those years they switched from the ECFMG to the dreaded two-day FMGEMS. MANY could not pass with the 90-95% failure rate of this “separate and unequal” exam. I lost three years of my life with that alone and THEN had to pay to be a fifth pathway slave in NY for a year (better than two years of Internado and social service in Tampico) We would take rotations ANYWHERE to get out of that Hole in my case inner city Detroit and Cleveland. Even if you get a residency (and all the double standard politics that go with it) you will end up doing primary care like me often in an out of the way place. I cannot imagine being a male nurse would be as painful as this…at least they are wanted and needed!

  114. An excellent article. However, the auther focused only on off shore medical schools following the American system. This gives the false impression that this is the only type of medical school in the Caribbean. The University of the West Indies is an excellent university with three medical schools. This school is patterned after the British system and in fact began as a campus of the University of London. The author has completely ignored this institution which is internationally recognized. While the emphasis was placed on American type schools a more balanced approach should be considered. Apart from this omission, the article was interesting and infromative.

  115. I have heard that students who study at carribean schools have a tough time passing the USMLE step exams. A cousin of my friend went to Ross and passed is Step 1 but has taken the step 2 twice and failed and is now looking to take it his third time. Is this due to the quality of educaiton and clinical rotation quality or just the student himself? please let me know thank you for your time

  116. man, all you DO vs. MD guys are hilarious. I think evidence of those out practicing medicine (whether they be DO or MD) speaks enough for itself: IT DOESNT MATTER WHAT TWO LETTERS FOLLOW YOUR NAME.

  117. Pranav
    Med school in general is mostly self studying/self motivation. Your cousin had trouble passing the boards not because of Ross’s fault, but mostly a fault of his own. If a particular US school’s average for step 1 was say.. 230, and you took all that student and have them study at SGU (can’t really comment on Ross since I don’t go there), i’m pretty sure that the average will still be 230. It’s more to do with the student than the school.

  118. it seems everyone is talking about top 4 caribbean medical schools.I am attending caribbean school other than these top 4.
    (AUC,SGU,ROSS,SABA).I am in top 3 students in my school and had very competitive scores in USMLE Step 1.I was wondering if
    I would be competitive enough for the residency positions in US/Canada.

  119. Go out to the street and ask every individual that walks by you: “if you had the option, who would you rather seek for medical treatment? An MD, a DO, or someone who graduated from a medical school in the Caribbean?”…I seriously doubt anyone would respond with the latter two. The bottom line is, and I can say this comfortably after attending a highly competitive pre-med school (JHU), there is a group of people who apply to MD schools, a group who apply to DO schools, and a group who apply to MD schools outside of the U.S; these aforementioned groups correlate to competitive, so-so, and poor MCAT scores, GPA, clinical experience, research (among other things), respectively.
    If there wasn’t any importance regarding the two letters that follow your name or the medical school that you applied to then we would all be meshed together into one, huge, clinical training school which is frankly ridiculous.

  120. I didn’t read through the million comments already posted so I apologize if this has already been stated. Aside from the increased difficulty in getting a desired residency, I think the stigma of having a Car. medical school stamp for the rest of your life is something that a lot of people (including myself) consider. I have had extensive health care due to asthma and sports related injuries and one of the first things I look for every time I get a new doctor is the medical school they attended. Obviously reading that someone went to SGU as opposed to someone who went to UCSD medical school will automatically make the later more desirable. Aside from this, I’m sure the medical education is the same just as a General Biology course at Cal State Bakersfield covers the same curriculum with the same intensity as a General Biology course at Berkeley.

  121. Wow so many opinions. Now I get mixed feelings about the whole MD vs DO vs Carib. schools. So for a person with not low stats like me, what is your suggestion? This year is my second time applying to US medical schools. I’m still in the reviewing status for most of the US (MD & DO) med. schools. I also tried two Carib. med schools (Ross & AUC). I got turned down by Ross. However, they recommended me to MERP. Anyone ever heard of this program? I was considering this option but it’s too expensive and that i couldn’t afford the tuition cost. I’m still waiting for AUC. Any suggestions on what I should do. I want to be a doctor more than anything. It’s just that I didn’t test well on the MCAT and my undergrad GPA wasn’t that high. I just finished my MPH with a pretty decent GPA. I don’t know if this would help. Please please help me…The application process is very lengthy and expensive.
    Thanks in advance!

  122. I’m sorry for a typo in the previous post.. actually “…for a person with low stats like me”

  123. St. George’s is the worst medical school in the Caribbean. It is the most expensive and living on the island really sucks, with the high cost of living and poor living standards. The school only cares about how much money it can make since it is a business enterprise, and dosen’t care about the medical students once they are admitted. The classes are over crowded with about 370-400 students admitted each term, and less that 50% of students secure residency. Even though, SGU will deny this claim. Each academic year at SGU, about 600 students graduate with an attrition rate of 10-15%. Amongst the students that graduate, less than 50% students secure residency in the first attempt. Check the school website for yearly residency matches and see for yourself if you are not convinced. If you are not an IEA student (the elite group of students at SGU), your chances of gaining a residency is very slim. Most students that graduate from SGU disappear from the radar screen because they fail to obtain a successful residency after graduation and end up doing a MBA, or changing careers with $250,000 in student loans to pay back and no license to practice medicine in the US or Canada.
    SGU has a great marketing campaign, with a flashy website, and nice campus buildings. Once you get out of this “SGU bubble life”, the rest of the country is a dumpster, and the locals make a killing on off-campus housing, local business making a killing by selling everything from food to entertainment at high prices. Most professors are foreign educated and speak English with a thick accent. When you take upper level courses like Path or Pharm, you are taught by foreign medical graduates that end up at SGU with the hope of getting a shot at a US residency program.
    The so called IEA students and other smart students seldom attend lectures and ace all the exams by self studying or studying in groups. SGU is definitely NOT WORTH the $250,00+ investment, unless your parents are filthy rich. Otherwise, you will have to pay a hefty $250,000+ loan for the rest of your life.
    My take on International medical schools is this; You can go to any medical school worldwide as long as it is approved by the WHO and the school meets US accreditation standards. California is one of the most difficult states to obtain residency.
    You can go to any one of these medical schools, get your degree, then take Kaplan USMLE prep, and ACE Step 1 Step 2 and CK and you will be guaranteed a competitive residency in the US or Canada.
    If you want to get the best bang for your buck, try some of the medical schools in India, Poland, China, or the Philippines. My friend went to a medical school in India and paid only $30,000 for the entire program, passed the USMLE board exams with high marks, and now is doing a Anesthesiology residency in CUNY downstate NY.
    So for those who want to become a doctor, but don’t have rich parents, these schools in India, Poland, China, and the Philippines make an excellent choice. US residency program directors don’t give a rats about where you went to medical school. Pass your board exams with high marks, and you will get into a residency. In fact, the quality of medical education in countries like India are far superior to any Caribbean medical school. Some of the Best Doctors and Surgeons in America are foreign medical graduates from Indian medical schools. Think long and hard before you make a $250,000 mistake with this high priced medical school.

  124. Thanks! What about the advantage of clinical rotations in the US that most of carib. med schools offer? To be honest, I’m scared of the location because caribbean islands are subject to earthquake and hurricane. The recent disaster earthquake was in Haiti. But I really want to look into other alternative options to become a doctor and can practice in the US. How about some of the med schools in Australia? Thanks again. 🙂

  125. The problem with these schools is they prey on the hopes and desires of desparate applicants. You hear of success stories, of those that successfully matched, but they don’t tell you about the more than 50% that don’t match anywhere. The fact that the top school has an 84% step 1 pass rate (and who knows what percentage of students that start there end up even making it to the step 1… if it is as high as 75%, then the pass rate is actually only 63% of those that start will pass first try) and that some are below 20% is astonishing, when the worse US schools are probably in the upper 80%. And while the caribbean schools do get clinical training in the US, they are all at community hospitals because large academic hospitals all have US medical schools and refuse these students. And the training difference is astonishing between the two places. I would feel much less prepared for residency if I only rotated at community hospitals. I am a US Senior and applying for General Surgery at only academic places, have not seen a single Caribbean student on an interview yet, and its not cause I didn’t look, it is because PD’s state: We got 1200 applicants, 200 from US seniors, and of those, invited 75… you get passed over for academic residencies 99 times out of 100. Ask most caribbean students how many places they applied to for residency: Most do 60+ for 10 interviews. I did 15 places for 13 interviews (interestingly enough, it was 2 community places that didn’t offer me interviews). So, yes, for those highly motivated, lucky few, you can go into neurosurgery from one of these schools… it hasn’t happened in a few years… and you can get a US residency in something (like was stated, something like 40-50% of those who graduate, which might be something like 50% or so who start, so really 20-25% of those who start at these schools will get a residency), but they are in no way ideal.

  126. well. You need to know one thing. If you do goto caribbean medical school. Be sure following
    No gaps during school
    dont screw around: need to be top 25% of class rank ( or better)
    No fails in any classes
    No failures in ANY steps with min over 210 (for even good chance)1sst try.
    Know your self. dont be a fool trying to apply to Surg if with low grade etc.( this is a key)
    MOST important: DO NOT listen again DO NOT repeat any class, or failures, including STEPS!.
    MAKE SURE YOU HAVE STEP 3 before you apply.right after med graduation.
    You are competing with your classmates for that same spot. there are hundreds of repeat applicants from your school alone.
    Dont think everyone from your class gets residency. Over 40+ % wont get a spot, ore more( dont believe everthing your school tell you)
    AGAIN: NO FAILURES. NO GAPS. Know how much you owe to bank.
    Think about money before you apply, not after. have Precise plan( this is very very important) if you screw up you will have debt over your eyeballs. Good luck

  127. Hello!
    I can tell yall are experienced in this field and i thought i should ask a question. My husband is a medical student in the caribbean it’s our last semester here on the island. He’s going to Ross med school. his 1st, 2nd and 3rd semester GPA has been 4.0 and hopefully 4th will also stay 4.0 …i was wondering if he keeps his GPA at 4.0 and he does well on USMLE 1 and 2…will he have a chance to be a Surgeon in the states… we’re originally from California but its very hard to get into med schools in the states as you can tell. So i was just wondering does anybody know a doctor that graduated from a caribbean school and is a surgeon now? My husband really wants to specialize into that but his hopes arent that high just because hes going to a carib school. And he graduated from UCLA with a 3.8 GPA and still didnt have luck anywhere in US 🙁
    SO please if you have some information can you provide? Thank you very much!

  128. Hi my name is Shay and I after reading most comments here, I am in need of postive/negative feedback. I graduated Cornell University with a BS in Engineering, but with a GPA of 2.87. I have worked for two major corporations since then (Intel and Samsung) and even got promoted with the first 2 years. However, I am not satisfied, and want to go to med school. I know I can do better than 2.87 this time around, as I have a goal. I have several options but my undergrad GPA scares me. I have currently started to get a Master in Engineering to take me vengeance out on engineering and prove it to myself that I can handle it. But I’ll come back to the main point here. My goal is to go to med school, and there are so many options. I am not even considering US med schools, because I know I have a tremendously low GPA. Considering Caribbean schools, there are too many options too. I looked at Antigua and they have a 6 year program. I am not sure if it required MCAT or not. Also, I am not sure if I should finish my pre-med sequnece (BIO 1 and 2, Chem 1 and 2, Organic 1 and 2, Anatomy and Physiology, Genetics, Microbiology, abd Biochemistry) while in US to prove it to the schools that I still have it within me. Any criticism will be appreciated.

  129. Dr. Freedman,
    Thank you for this article and the important information.
    Two reasons I’d consider a good school, Like St. George:
    First, I’d do this to save a year on my road to medicine–seriously. I’m a nontraditional and shaving off even a year is helpful. Not so much to me, b/c I see the age factor as highly relative; but b/c others, whether they admit it or not, are fixated with numbers and age.
    Second, OK, well honestly, the climate, atmosphere etc. Sure it’s not party time. But if you have to keep your head in the books, you still have to periodically come up for air. Grenada looks like some nice air to come up for! And it’s only two years at SG, and then you’re off to one of their approved sites in the US.
    Third, I know a person that went this route and completed clerkships and residency at NBI–pretty busy place, and he learned a lot.
    If you are focused on going to med school later in the game (not say a 21 or 22 y.o.), a place like SGU is not necessarily a bad deal at all. I think the worst part of it is the overall expenses. When I do the calculations, I am coming out over $50,000 more compared with most US med schools. And in retrospect, I think that may be a little lower than reality, when you consider airfare and other living and moving expenses.
    Fourth, I also think it would be cool to go to school with an even more diverse group of people–a good number of students that are not from the US.
    Thanks again for the article.

  130. Shay
    I wouldn’t even worry about getting a masters in engineering. It will help you very little when time comes for applying to med school, but it will help you if you decide to stay in engineering. Take classes in biology/chemistry that are required prehealth and do well in those and prepare well for the MCAT. That is the best you can do now and best of luck to you.

  131. hi,
    First i’ll start with saying these are just my two cents.. i’m not even comin back on this forum to argue or follow up any comments, so plz just take the info for what it is, and ignore it if u dont like it. =) Excuse the grammar errors and internet short hands. im just typing as i think and not giving a hoot how it looks as long as its legible.
    I’m a 4th yr student at Ross, just providing some insight from experience, and trust me- im not biased – i used to hate ross with a bigger passion than most ppl even though i never failed a semester and did well on my USMLES (>90)
    if I had to choose carribean again, i’d have chosen SGU first, Ross, then AUC. Only bc SGU schedules rotations for their students b4 they even pass the step (like the US med schools), and its not such a hassle for them and finally they have bought out the better clinical sites from ross and auc- money talks….
    i’d pick ross before auc bc my best friend goes there (I told her to go there after 3 sem’s at ross thinking it sucks–i was wrong.) Because if you fail one class at ross…and recieved A’s in all the rest, u must redo the entire semester no matter what…at AUC.. u can repeat the same class over n over..and not be afraid of being kicked out as it is in Ross and u can move forward per semester. Granted, ross is full of sharks…but thats the only way to make it. Also there is an exam called NBME COMP exam administered at Ross and AUC before the usmle step 1 can be taken. Ross requires a pass equivalent to that of passing the usmle, in order to even sit for the USMLE (they obviously want their pass rates to be high), AUC has a lower requirement , granted its only a few points… it just bothers me to know its less.
    I have worked alongside students from AUC and many other Caribbean schools as well as D.O schools, and even students from american schools of the University of California system…. this is what i noticed…
    Students from AUC, SGU, were not any different than at Ross..except personality wise- at ross.. u get trained to be a shark…theres always much more at stake if ur at ross, and therefore they tend to be the over zealous students who will do what it takes to push others out and be successful….i’m not sure if thats a good thing, or bad thing..thats left to interpretation. The island is the worst at ross,the curriculum is harder than the rest, in terms of having to do what u can on ur own and not being allowed many 2nd chances…. knowledge wise, when being pimped— people varied…just like ppl vary in personality. However—- i definately noticed people from other caribb schools…. although many my friends (and nice people)….lacked the confidence we from the top 3 have…They did not appear as competent on the wards, even though they passed their USMLE’s as well… Just something we all noticed… in the end confidence takes over……….. now on the other hand, the UC students from US med schools… did not welcome me…
    Its true i’d have gone to a US school if i could have, so with them- its simple. instead of being angry…just earn the respect…discuss the medical knowledgable….and they automatically recognize a good doc. I’ve been told, although apprehensive towards me at first, later they said “youre going to make a great doctor”… you make urself stand out in the end..
    The stigma will always remain, the debate will continue…there won’t be an end …..but in the end of the day ….the purpose of this difficult and long path was for medicine and helping society. I have personally met an arrogant resident from the UCalifornia medical system who was wrong on a diagnosis and arrogant enough to not accept my 2cents bc hes an “AMG”….lo behold, i was right. It happens……. I have also met students from my school who were complete morons and i have thought to myself over and over “how did they pass the step?”….. I wouldnt want any of those two ppl to be my doctors.. whether the wrong diagnosis is made out of being arrogant…or just a great memorizer and not being able to apply medicine to real life…. I don’t want any of those doc’s near me or my family. So it doesnt matter where u are from in the end when the patient is in front of you and their health is in your hands……
    I also worked with many DO students…theyre on the same page as well -they didn’t appear any more or less knowledgable at all. One thing that stood out– i have seen them do OMM on patients, and at times found it fascinating, and other times useless IMHO.. so it varies…but I have to agree with earlier posts… DO is NOT MD..they spend extra time learning things we don’t, but if they arent willing to apply it, they are essentially no different than FMGs who took the 2ndary route.
    There are options to do fellowships training in OMM if u are an allopathic doctor, so you can learn what they did. But in reality out of about 40 DO’s I worked with, 4 actually implemented OMM on their patients…2 of them just amazed me so much with it. I personally witnessed the patient’s gratitude…. but the rest- didn’t even care for it.
    I personally rotated at a hospital, where if you were a DO resident, you were promised into opthamology or dermatology, after completing a full 3 year residency in family practice….ended up putting you in the ‘6’ year plan..but hey if its worth it for you it is….. Now — FMG’s sure don’t have that option.–if we could do FP then Derm…it would be easy! unfortunately its not possible.
    However the DO student i worked with closely said to me himself, there were many programs that did not accept D.O ‘s into their allopathic program that he was interested in, and that technically means an FMG can apply (although rarely will get in) … So if there are programs that like D.O’s over FMGs……. there are certainly those who will not even accept D.O’s as well bc allopathic medicine is all they allow… It all balances out.
    I respect them and their different approach to medicine – but IMHO, if you chose DO school you should practice medicine and apply the OMM, instead of forget it, and pretend DO school was just a vessel, and end up in Allopathic residencies. It just doesnt make any sense to me at all??? I personally declined DO due to the international problem bc I like the option of being abroad…but if u never leave the states….who cares. BTW, the OMM i saw being implemented were on inpatient wards on Pulmonary patients, as well as OB/GYN (not ur simple primary care — so they have no excuse, they dont have to be a typical primary care doc to do OMM) If ur a proud of it.. n be a DO…I dont understand the route to allopathic residencies?
    AMG’s definately must have done something right here n there, besides working their butts off to get into school ,and they do deserve the right to scrutizine us….I can sympathize with their frustration toward carib grads or DO’s who to them took the “easier” route…… BUT it is also true, its harder for us to get where they end up….and BC of that…most of us end up as excellent physicians..not just book smart but street smart.
    Finally ….. to the person who stated they (AMGs) have better rotations that are academic, vs our community hospital ones… YES.. it is true……. BUT……… look at me as a prime example.. if your scores are stellar enough…. you have the option to apply into some of the same places and rotate along side them.. It comes down to ur scores and motivation to get the ‘better’ clinical training sites.. OR…at the community ones… you have to ASK the attendings to do more procedures, ask tons of questions…basically its all in your hands how much you want to learn……
    If i could go to a US med school, i would have… but i also wouldnt deny that living on an island has taught me much much more than I would have ever dreamed of.

  132. should i consider applying to Medical University of Americas? im currently a 3rd year student in pakistan at Dow International.

  133. Can anyone please give me some info on American University of Antigua ? I have been accepted to their Pre Med program but I am not sure how it is. Also does anyone know if the 4 better schools have pre med programs for high school graduates ?

  134. Would somebody, with FIRST HAND experience/knowledge, please advise me on applying to a Caribbean Medical School. I graduated from Ohio State, I have both an undergraduate and graduate degree (Marshall University Huntington, WVA). I had planned originally planned on medical school but used the Navy ROTC program to pay for my education. I took the Marine Corps option and flew jets and helicopters until an IED attack in Iraq ended my career of 15 years. I’ve always regretted not going to medical school and feel now is perfect timing. I love the challenge of medicine. I’ve been a Paramedic for 19 years and I’m very skilled and competent. I feel I’d serve my community better as a physician. I don’t care if it’s an M.D., D.O. or B.S! As long as it says “doctor” and it allows me to be licensed in the U.S.A it will work for me. After all, many of my closest friends now are very accomplished physicians. Many of them say the same thing I have heard on here a lot. The residency makes the doctor, not the school. It’s been too long (personal opinion) for me to try the standard ways of applying to the US medical schools. I doubt I’d fare well on the MCAT and I am ready for immediate patient interaction. BUT, I have medical needs myself. I now have to take many medicines secondary to my injuries which unfortunately include controlled medicines. Will this be an obstacle for me should I go to a Caribbean School? Not that I’m worried about being trusted around controlled substances, but can I find a physician on the island while there? Thank you for your time and attention.

  135. I attended AUC a number of years ago.I did my clinicals in London and residency in North Carolina.I am now a Board Certified in Family Medicine.I now have the best job in the world.My advice is to tune out all the negativity and follow your dreams.The debt is really a trivial issue.I have a job I love and employment stability for the rest of my life.Ther are some very long days…and the hours can get intense.But AUC help me realize my dreams and I will always be grateful!

  136. hi all,
    I am a caribbean student attending medical School on one of the islands. I would like to say that I have never heard of any of the medical schools mentioned thus far. The major medical schools found in The caribbean are in Barbados, Jamaica and Trinidad. My advice would be to stick to those ones … as recommended by a caribbean student.

  137. I keep reading that some residency programs do not accept foreign medical graduates. Does anyone know which programs these are?

  138. I attended St. George’s University from 2003 to 2005 and was very happy with the education I was granted there. It led me to do well on my board exams (steps 1-3) and although I was able to transfer to a US medical school, I am still thankful and appreciative of the wonderful education and the amazing experiences I had in Grenada. I would have been more than happy to have graduated from St. George’s and I wish they would give me and honorary degree. I am currently midway thru a plastic/reconstructive surgery residency and no way regret my decision to go the caribbean for medical school.

  139. I am an American born graduate of a Caribbean Medical School (Ross University) and have been in practice for over 20 years. I am board certified in Family Medicine which was my ultimate goal. I was warned that going to a foreign medical school would be a “dead end path”. I chose to ignore these warnings because my father who was an orthopaedic surgeon for over fourty years before he passed away had also been an American born graduate of a foreign medical school (The University of Lausanne in Switzerland) and had been given similar warnings prior to his study abroad. I don’t want to sugar coat my experiences. I had to work very hard, first to get through my studies and then to overcome prejudice and road blocks from a self-serving medical establishment. Along the way however there were many individual mentors and hospitals that provided me with the opportunities that I needed to complete my training. It was much harder for me to find a residency position as an FMG, but I was ultimately successful. One of my classmates even managed to get a surgery residency followed by a cardiovascular surgery fellowship and is at present a very successful cardiovascular surgeon. While he is the exception and not the rule, my point is that it was still possible for him to accomplish this with luck and hard work. In over 20 years of practice I can count on one hand the number of patients who have asked me where I went to medical school. Their main concern is whether or not I provide them with good medical care. My son was recently accepted to an American Medical School and he was very fortunate. There will be some doors opened for him that were not opened for me, but ultimately he will be judged by the physician that he becomes and the quality of care that he provides. That is true for any graduate of any medical school. At the present time it is extremely difficult to be accepted into an American Medical School and schools are turning away many very qualified applicants. This is clearly nothing new. While there are no guarantees in life, if becoming a physician is your life’s goal, then use any pathway available. Schools like Ross, AUC and Grenada are opportunities, not guarantees. Research these schools carefully before you apply and commit thousands of dollars and hours. You will have to work very hard if you attend any of these schools, but you can and will succeed if you have the desire, the will and the strength of character.

  140. As a Black American, not someone who has ties to Africa, but an American born citizen, my family ties date back to the 1700’s, merican slavery. I have never in my entire life had an American trained non-Black physician in my entire life. Everyone of the physicians that dared to treat the people in my community were trained in medical schools outside of the US. Not one time did I question the doc’s knowledge, he/she was a doctor, enough to earn my respect. Also, he drove a nice BMW, in my opinion he was doing quite well for himself. I say all of that to say that in the end, it is the patient who the doc should try to help, save, and please. Now with that said, we Blacks need doctors, help, train, earn a medical degree from any medical school, and please if you are given the opportunity do not turn down the opportunity to treat patients, because again in the end you learn medicine to save lives, everything else, all the praise from your peers and your family/friends is the icing on the cake! I hope this helps. Earn a MD or a DO, but train and treat the patient, many posts on this board represent classist ideas and deep fears of anything and anyone that is “different.” Get a life, become a doc!

  141. Sorry for not editing my earlier post, but I was so bothered by the earlier posts that I just felt a need to encourage the future doctors.

  142. If you are planning to do this, please don’t. The websites of the Caribbean schools look so fake. Go to any top schools website from the U.S and tell me if the website are like that. I rather get my bachelor’s degree, take the MCAT. Those schools are dream killers.

  143. To Tif: I am from Jamaica and those schools that you are talking about in Jamaica, Barbados and Trinidad are NOT US accredited schools. Those are excellent medical schools for practicing medicine in the islands ONLY which is probably why you haven’t heard about Ross, St. George’s etc. I will be applying to medical school this year and I will be applying to these US accredited medical schools as realistically my college GPA (University of Florida) is low due to family/personal problems. I’m just trying to reach and realize my goals and as someone said before yes Caribbean schools have a stigma attached to them but I don’t care. I believe you make the school, not the other way around so if I get accepted I will try my best to make the best grades I can by using all the resources presented to me by the school so that I can get into a good residency. I suggest everyone try to do that. Just because you went to say, for example, Harvard (because you got the grades) doesn’t mean that you are going to make a good physician. I’m just saying…

  144. I went to Saba University. And i’m proud of it. out of a class of 40 students…38 actually graduated and all 38 completed residency and as far as i know are practicing.
    All i can say is that if you stick to the program you will achieve your goal. Apply to the caribbean schools you like, attend one, study hard and learn your basic science well..take and pass step 1…complete your core rotations…take step 2…complete your electives and graduate. You WILL succeed no matter what. you may not get radiology…but you will get a residency spot if you have any talent at all.
    Do not let anyone discourage you. there are lots of horror stories, but if you realize that you have to study hard, stay focused, and keep looking forward to your next goal…you will become a physician.

  145. Hi, In my case I study veterinary in Dominican Republic my college is Universidad Autonoma of Santo Domingo our program last 4 1/2 and our degree is lic. veterinary medicine. I need to know what can we do to work in USA? and if I am a tech in USA, what can I do to become a DVM?

  146. @Morgan: Not everyone is interested in Medicine in order to be a “high paid surgeon”…

  147. I attended and graduated from a caribbean med school. I am now a neurosurgeon. Med school is what you make of it.

  148. I have a friend that went to the medical school in Caribbean and that person did not make the residency match for 2010. She is currently trying to find a job and focusing on future examinations. It’s very discouraging, but there is a lot of competition for residencies and each year there are more applying for spots. I wonder if she will get a spot for next year? There are not enough seats for medical schools in USA and certainly there are numerous students who have good or high GPA, MCAT scores, and meet other criteria for US schools, but they get rejected due to competition so they go to Caribbean. It’s definitely easier to get into Caribbean schools and I’m sure there are tons of students who are not medical material applying to these schools. I do find it disturbing how easily Caribbean schools take students, but once in the program the strong are able to become doctors. It is a profit school because it takes a lot of people, but some are able to become doctors and able to continue on with their medical career. US and Canadian schools take the most qualified and screen out people. Caribbean admissions take as many as they can and if a student struggles through the medical program and not get residencies and such you are on your own, and your money goes down the drain. I also know those people who lost their money and basically came back from the Caribbean medical schools basically they weren’t able to progress. Certainly there are some exceptional doctors from Caribbean, but the rest are questionable.
    I agree with Joey.

  149. No matter what medical school you attend, make the BEST of it & bring a POSITIVE ATTITUDE!!!! =]

  150. I am wondering why so much focus on Caribbean Medical Schools as an alternative to US Medical Schools. There are many East European Medical Schools that are open to US and Canadian students, are much more established that Caribbean schools, have much better reputation and many graduates in prestigious fields like surgery, neurology, ortho etc.
    Why are these East European schools not considered as a better alternative? Just curious.

  151. @Rash Akh
    “Why are these East European schools not considered as a better alternative? Just curious.”
    This is because with the Caribbean schools, you get US clinical experience, which is needed for admission into most US residency programs.

  152. Hi,
    I just wonder what degree I would receive at the end of the 4th year if I went to St. George’s University (SGU)? Is it gonna be an MD degree from SGU or from the place where I did the clinical years?
    This does not seem clear to me at all even though I have read quite a lot about SGU itself and some other Caribbean medical schools… Can someone help me with these questions? Many thanks

  153. As a graduate of Ross University I say this: Go to the Carribean if you can’t get into osteopathic school. I don’t see a difference in DO vs. MD (Carribean) other than the COMLEX and Osteopathic Manipulative Medicine. Both pathways allow for residency in the US. With the osteopathic route, you get to stay in the US for the entire four years instead of travelling thousands of miles away to a third world country.

  154. Kent you will receive a degree from St George’s University. The carribean schools generally have headquarters in the US. For example, Ross is located at New Brunswick, NJ.

  155. @ TK: thanks very much for your response.
    to anyone who knows an answer to this,
    as an international student from Vietnam, where and how can I borrow loan from to cover my tuition and fees? I may have enough fund to pay for the first year of school, but then I have to get some sort of loan from the second year onward. Can someone advice me on this? Many thanks

  156. Here’s a brief summary for all who are thinking about med school abroad. Go to schools in this order if possible:
    1. Go to US Allopathic schools
    2. Then go to US Osteo schools
    3. Go to the best US modeled caribbean schools
    Only St. George, Ross, and AUC are qualified to practice in all 50 states, get federal loans, and have years of experience to back their claims.
    There are some other med schools that seem to be alright and improving -like AUA,Univ med at Kitts, etc, but they don’t have the same reputation of reliability that the big three do. They aren’t my first choice, but they are still an option.

  157. why is it not made possible for foreign students like african students to attend carribean medical schools,even if it is self sponsored.i have tried time without number to access a medical career to no avail…can you please help me enroll into a medical school as self sponsored or fee paying student?thank you very much.

  158. As an academic physician, please do yourself a favor and DO NOT go to the Caribbean. Better options are: DO schools or taking a year off, study hard, volunteer, get another degree or a Master’s and apply again. As an FMG, it is VERY hard to get a residency spot and nearly impossible unless you want FM, IM, PEDS or Psych.

  159. I have a friend who went to a Caribbean school a few years ago. He is now in residency.
    Unlike what some have stated here, it doesnt matter if you end up failing a semester due to a class. Your medical career will not end there if you keep at school and have a positive attitude and pray.
    So yeah, about my friend. He failed not one but two semesters in med school. (He failed two classes and had to repeat the entire semester for that.) He then took boards, failed Step I the first time and passed it the second time. His score was below 83%ile, I forgot what it was exactly. He did not make the Match, he had to call around and apply.
    He called around and got an interview for residency at one place. Almost everyone interviewed had a higher board score than him and had passed STEP I on first attempt. They were interested in him. But then something happened and he ended up being called by another Residency program and got in there as well. Thank God.
    He is now in Residency in Family Medicine. Now here is the interesting part. Having done different rotations in Family, he has been offered to do residency programs in Internal Medicine, Radiology, and one other. The point is, once you get your foot in the door, if other program heads like you, you can switch. This is something a lot of people simply wont tell you.
    So what does this all say? Dont give up and believe in yourself. And dont believe the negativity that people tell you. You can do what you put your mind to and pray for.
    Be positive and pray. Dont give up. It may take time, and it may not be totally ideal, but good things can happen even if you dont have the perfect resume/grades/scores.
    One thing I was told is, keep track of what you do everyday after you graduate med school till the time you start Residency. Programs will want to know to make sure you werent doing anything you shouldnt have been.
    Be strong!

  160. I went to a US med school, I was dismissed. I went to a Caribbean medical school and stuggled to finish but I eventually did. I can say carib schools are WAY WAY WAY HARDER than us schools. Classes are much more difficult, exams are harder, if you fail there are no retakes, you are just dismissed. Any behavioral issues you are dismissed.
    Don’t take carib schools lightly just because the admission is easier. They are much more difficult than US schools even.

    • Very true. I have one son and his fiancé who are now in their last year of residency and another son who just completed his first year successfully. Brutal! You’ve got to to be 150% dedicated and disciplined.

  161. I got 21 on MCAT and ny GPA 3.58 .I have enough credits to graduate in January 2011 . Do I need my BS or apply to Carribean med schools on January ?

  162. i am a carib 4th year at sgu. i got 99’s on my boards. i applied to surg on wednesday. it is true that some programs wont even open your file. no way to know which ones, necessarily. but some excellent progs will take a look at you. i have to disagree going DO over MD. DO is a title that you ahve your entire life. the majority of non-medical folks don’t have any idea what DO’s do.
    the reason you dont hear about the places that prolific doctors went to school is due to the fact that as you take every step, the last step is the one that gets focused on. e.g. who asked you where you went to high school when you were in medical school? who asked you where you went to college while you were in your residency? who is asking you where you went to medical school while you are in your fellowship? as you climb the ladder, people are interested in the last rung that you stepped on, not the ones on the bottom. if you want to be a dr, regardless of what type, go to a us school if you can. if you cant (low gpa or low mcat) go to a carib school. call sgu 1800-899-6337 ext 478 and talk to a student. they have an entire office of students that will give you, albeit objectively, their experience on the island and w residency applications etc… i was one of these students when i was a third year and the people that called had a LOT of questions answered. best of luck to all.

  163. studentguy fails to mention that D.O. grad will have a much better shot at competitive residencies than the Caribbean grad. No one cares about the initials following the name though…
    Caribb… last option.

  164. It is a good option. Actually a great one for those who can afford it. I make every effort to encourage non US pre-medsters who can’t get into an on-shore school to ROSS as opposed to a DO school. The originators of the school back in the 80s had some difficulties placing 3rd and 4th year students in clerkships, the core clerkships Med, Peds, Surg, Psyh, OB-Gyn but managed to make some solid inroads. I know this because I helped a number of students get situated. In the early days it was a messier world for offshore med schools. At the time I – late 70s early 80s I headed to Mexico. When people who wanted to go to med school or change careers DDS, DMD Chiros etc., DOMINICA/ROSS and staff were there with innovative programs. Keep up the good work.

  165. I don’t mean to generate anger or steam here, but, if you don’t have the numbers to go US MD I would highly recommend going DO over international MD. Some above have mentioned above that DO is something that nobody knows about. My answer is: who cares? I feel that DO is a better option because you learn hands-on manipulative skills in addition to the traditional MD education that you would not in the caribbean.

  166. On ABC’s Boston Med show, one of the cardiothoracic surgeons attended St. George. A Ross Med grad, Dr. Rezak, trained in trauma surgery at Brigham and Women’s hospital. Her twin sister just completed her plastic surgery training at the Cleveland clinic. Another Ross grad complete a radiology and was recently accepted at Yale for a fellowship in neuroradiology.

  167. My GPA is less than 3.5 (C in O Chem). I was considering alternatives and someone mentioned podiatry. I followed the Why I Chose Podiatry thread and it is frightening. Are the posts really representative of podiatry podiatrists and a profession in disarray? My guess is that there are some real isssues in podiatry and will be pursuing acceptance to Ross. At least I will have a chance to take the boards and have a main street career. I think that I wasted my time with podiatry and podiatrists. Anyone else headed to Caribbean after checking out podiatry school? It really looked like a viable career choice until I started doing some research.

  168. Judson,
    I’m truly sorry to learn you had a bad experience with your doctor. However, to blame it on where the physician went to medical school is incorrect. Can one blame the surgeon who had operated on the wrong side of the body on where he went to medical school? I believe this one MD attendend and completed his medical school, residency/fellowship at top tier US medical schools. No, you can not because medical school only comprises about 1/2 of medical training. In order to become a fully licensed physician, one needs to complete residency which is at least another four years of training. Many would say residency is where an individual really learns to become a physician and not medical school.

  169. My question is why does it have to be caribbean. Can’t someone go to a medical school in other industrialized or first world countries. China has medical schools that accept international students.
    Israel another good option and so is Canada which people don’t mention. There’s other international options. Malaysia is another. Dubai etc. etc.

  170. Also I agree with the comment Dec 19 2010. One doctor does not represent an entire school so its unfair to base the opinion of a school’s education based on the error of one of its members.

  171. For the UK, there’s schools that take international applicants and the UKCAT is a test based for high school students which is probably less difficult than the MCAT and having a bachelor’s degree would impress these schools.

  172. With a 3.5 why not go the D.O. route? Are you that hung up on those two letters? Caribbean should be the last… last… very last option. After more more undergraduate classes, post-baccs, SMPs, and a few solid shots at the MCAT, THEN, one can shrug their shoulders and go Carib. And even then… I’d rather go overseas.

  173. Blah,
    The DO route for me was the last option. I graduated cum laude from a great college in Chemistry. My MCAT was 28. I chose Ross Med School instead and has been an attending ED MD for years. Having trained various DO trainees and listening to their insecurities and complaints, mix bag of clinical rotations, difficulty of gaining MD residencies vs. the low quality DO residencies, respect?, etc.-quality Carribbean Medical Schools such as Ross, SGU, SABA, AUC can be great choices for many smart and motivated aspiring physicians and not the ‘last option’. For me and many of my classmates, the DO route was not even on the table. And all of us are practicing medicines in pretty much all fields of medicine throughout the country.

  174. @bbfan88
    There are two reasons the DO is frowned upon
    1) If you wanted to practice in another country, they would not recognize your doctorate degree. However, most countries recognize the MD degree.
    2) Because the accepted social norm for the degree a physician should hold is an MD. Most people in general deal with MDs and are not use to being treated by a DO.
    I don’t mean to bash on the DO. I hope it stands on equal ground in the minds of people as the MD one day. I believe that we should look into alternative medicine as well so health care one day can be more integrative.

  175. It does not matter where you went to medical school. It matters how good of a doctor you are. Quit judging people by where they went to school. Honestly, who cares. Good doctors with good bedside manner are hard to come by.

  176. This article was thorough and concise, an overall well-written piece. I was hoping to read more positive, promising feedback from doctors that attended schools in the Caribbean or any international region and how they “measured up” during residencies against colleagues from schools in the U.S. Sadly, there seems to be an egotistical quest for omnipotence among some contributors, instead…
    Newsflash, people: “MD” or “DO”, or any other title for that matter, does NOT make you God.

  177. When people starting choosing Carrib MD over lesser known US MD-granting institutions, then maybe you can come talk to me about equivalency. Fact is, some people actually DO choose the DO route over MD, especially if they know primary care’s their route. The same can’t be said for American-born IMGs.
    I don’t mean to demean individual doctors, but, come on, as a patient wouldn’t you as a rule feel more content with a doctor that was bright enough to make grades and pass his MCATs? Undergraduate organic chem isn’t exactly rocket science.

  178. Carib Canadian, you are most definitely an outlier! Sorry, but 9 out of 10 people with the stats you mentioned would wait it out a year and get into a U.S. school because it WILL improve one’s chances of attaining a more competitive residency. That’s not opinion, that is truth. And it is not about which is better, it is about how the degrees will be perceived by residency programs. Like it or not, if it came down to a Carib grad and U.S. grad for a spot, the U.S. grad is getting first dibs.
    I don’t think the discussion is about narcissism. It is about making an educated decision and playing the percentages. Also, there are moves to eventually limit access of Carib med students to U.S. rotations in a few states. Add the fact that there are a number of new U.S. schools opening that will only lessen a Carib grad’s chances of matching during Senior year. Again, this is not opinion or some holier-than-thou attitude; it’s simple a numbers game.
    The Carib schools are a good LAST option when all others have been exhausted (post-baccs, lag year, SMPs, etc). Now THAT’s MY opinion.

  179. Also, I highly doubt that there are many at Ross with those stats. In fact there are not many stats like that at a number of middle tier M.D. programs. I’m calling BS on this one. Sorry.

  180. My dear blah,
    “it came down to a Carib grad and U.S. grad for a spot, the U.S. grad is getting first dibs”.
    – I completely agree with you on this one. However, I believe that a lot has to do with the current perception. Sadly a lot of that perception is heresy. Trust me, I know what you feel, and I possibly had similar thinking and a similar image of the Caribbean schools, when I was in undergrad. This was mostly because of the rumors I heard, and so I do NOT blame people when I hear such things from them.
    What changed my outlook was my ACTUAL presence on the island, AND my comparison of medical students from Ross/St.George/AUC vs. American/Canadian students.
    The differences are VAST, when you compare the initial incoming classes, but over the years, those differences simmer down, and the students are virtually indistinguishable in their medical approach and practices to the mainland counterparts.
    The differences arise because unlike US/Canadian schools, the weeding out process in Caribbean schools occurs DURING the medical education vs. BEFORE.
    Sadly, marks, points and scores are the primary determinants of a person’s ability in this day and age. (The use of alternate methods is a topic of another discussion). Thus, many intelligent, talented, dedicated, capable students(and adults) are weeded out of the Canadian and US Medical school match.

  181. The Caribbean universities give such people a chance of pursuing their dreams. Those who CAN, make it through the other end, those who still CANNOT, get weeded out (at least at the big 3 Caribbean schools). But at least they get a fair shot.
    Those who do make it through are mostly the ones who would have succeeded and prospered in US/Canadian institutions, but were unable to do so because they were never given that CHANCE, that one SHOT. I got weeded out, because most Canadian schools end up having an unofficial GPA cut-off around 3.90+. As a Canadian, I am obviously overshadowed by American applicants to US schools. Many other applicants to the Caribbean schools have their own such reasons.
    In terms of differences in the students, as I said before, there are always going to be good doctors, and bad doctors; and that is always decided on an individual basis, because as a school, “you can always bring the horse to the water, you cannot make it drink”.
    “The Carib schools are a good LAST option when all others have been exhausted (post-baccs, lag year, SMPs, etc). Now THAT’s MY opinion.”
    – I do not disagree with you here either, and do not blame you for thinking that way. My friend and classmate who got a 274 on the USMLE Step 1 promptly transferred to a US school for the very same reasons. However, that being said, these rumors of “under-trained” Caribbean students will someday soon be quashed.

  182. Hey I’m not knocking students who graduated/go to the better of the schools down there. I have known a few who are their way to becoming exceptional doctors. I hold no prejudice against grads/students from there. Funny thing, I was on my way to school this morning and a woman stopped me and asked where a local hospital was. She turned out to be a Ross student on her first day of rotation here in town. Not an ounce of “ooh, a Carib student” went through. All I could think (and say) was kick some butt and good luck!
    Anyhow, I have to study myself. Keep doing you’re think Canadian. Ay!

  183. One thing that i did not see on this article that you should check into when going to a caribbean school. Is that if you do not pass the boards if you will get an MD behind your name. My husband went to a medical school in St. Eustatius did his residency at a hospital in New Orleans and Internship in Chicago. He is extrememly intelligent, but was unable to pass his boards. He is now working as a pharmacy tech trying to pay off student loans. Both of us work 2 jobs to pay his loans, and he constantly tries to get a better job, but too no avail. Just an FYI!!

  184. I agree with the previous poster that it is simply a numbers game. Take a look at the “independent” applicants in Charting the Outcomes in the Match. This is from 2009, not sure if it’s the latest one but you get the idea. Also, it seems to be only getting worse with time.
    Doesn’t look like they differentiate where those independents actually come from (ie which school, country, etc) but since the matching is ~%50 at best, less in most specialties, I would go US all day.
    They break it down by USMLE scores as well. For example in anesthesiology, the first specialty on the list:
    Those with scores from 221-230 (pretty good scores)-
    US Seniors who didn’t match: 11/267 (4%)
    Independent applicants who didn’t match: 47/65 (72%)
    Even if you get 251-260, a ridiculously high score, as an ind. applicant, 4/11 still didn’t match. Step 1 scores don’t mean a whole lot. It’s all about the school you attend, unfortunately for those bright applicants who THINK they have no other options (that’s what the carib schools want).

  185. It’s really not the school. It’s the individual! If you do well on your boards then it will speak for itself. Any medical school gives you the chance to take USMLE’s. If you do well, then residency will be obtained. Work your tail off during residency to get a fellowship. Do well on your speciality boards and subspecialty boards and life will work itself out. Don’t distract yourself from things that you cannot control. Even if all US grads a granted residencies, there will be a ton of left over spots that are available. Focus on learning the material and do well on boards. Success will be obtained. Fail the board, then you are completely screwed.

  186. If you want to go into primary care, i’d suggest DO school. Reason being, a good chunk of your time is spent treating musculoskeletal systems. During my clinical rotations in family med at an allopathic/osteopathic hospital, i was shocked by the poor understanding of anatomy of MD students.
    For instance, they didn’t know origin/insertions of basic muscles, never heard of standard diagnostic tests, and worst of all, was SO AFRAID TO TOUCH A PATIENT!
    The US MD students I’ve rotated with tho were, however, very smart in textbook Q&A- I will hand them that. So if you’re interested in Family Med or PM&R, i suggest DO!

  187. Hi Blah,
    What you say really does not make any sense at all. There is an obvious physician shortage and at this rate it is just getting worse. Increasing more medical schools will not help at all. We need to increase more residency spots if the Medicare budget will allow it at this point, especially in this economy and funds slowly drying up.
    After, all the research that I have done, it all depends on what your independent philosophy on healing is. There is no degree better than the other, whether it be an MD or DO. About 25% of all practicing physicians are considered International Medical Graduates and all my physicians obtaind their degrees from schools that were not accredited by the Liason Committe on Graduate Medical Education, which only accredits US and Canadian schools. However, there is also a seperate list in which the LCME also deems the other accrediting bodies that are equivalent.
    I just think it’s all about lame elitism. A lot of the major medical findings were found by interational medical graduates (IMG). The human body is the same all over the world and so most doctors are not asked where they received their medical degrees. Once the USMLE examinations are passed and they go through residnecy, I have never heard of one doctor putting down another doctor because they went to a foriegn medical school. I think that is ludicrous.
    Thank you

  188. Hi,
    In addition, I have researched all the major big 4 Caribbean schools and my own doctor also has recommended going to SGU if I could not obtain medical school admissions in the US. He is been a family doctor for decades and he said there are other great alternatives rather than going to a US medical school.
    It all depends on the individual and the route in which what decides to pursue. If you go to SGU, ROSS, AUC or SABA, then you do 2 years abroad, take step 1, do all rotations at AGCME accredited hospitals, take step 2(CS, CK), do elective rotations and apply for residencies. I know SGU has the best reputation and it’s only gettig better at this point.
    I do agree that primary care is no problem at all. There is a huge demand for primary care right now and for the future. Family practice, internal medicine, pediatrics and psychiatry is all very open and there are no major problems with this. However, there are specialties like the radiology, dermatology, surgery and opthamology which is tough. But there are exceptions. One of my cousins landed a an opthamology residency at Harvard and he graduated from a medical school in Pakistan.
    So I think we all need to relsx a bit, work very hard, get those letters of recommendations, get the deans letter, get great USMLE scores and give good interviews.
    Thank you

  189. The fact that medical schools are increasing class sizes and more medical schools are being established, but residency spots are not increasing is precisely the reason NOT to go to any foreign medical school if you want to practice in the US. Residencies will virtually always choose a US medical school candidate over other applicants (MD or DO). Check out that link I posted before, USMLE scores aren’t enough.
    Even as recent as 10 years ago, Caribbean med schools were an option, which is why PRACTICING doctors ‘recommend’ it. But given the current trend, they simply should not be any longer. Ask any program director, they will tell you the opposite of what the previous poster claims.

  190. I do not think it to be a bad idea at all. Caribbean Medical Schools quite appeal to me as a last resort should I not get into Medical School in my home country or the other parts of Europe.
    I think they are of good standard.

  191. I’m graduating from medical school in June, and matched in a competitive residency in the Bay Area in California. From this year’s NRMP breakdown:
    # of US trained allopaths (MD’s) that match: 94%
    # of Osteopaths (DO’s) that match in the ACGME: 71%
    # of US-Citizen Foreign Medical Graduates that match: 50%
    # of non-US-Citizen Foreign Medical Graduates that match: 40%
    This is just the numbers from the NRMP. Just presenting objective data.

  192. My 41 year old mother was misdiagnosed by a top _4 educated neurosurgeon. She left behind two small childrenm So I doont understand what is so important about. Where you were educated? My son applied to US schools with top scores and did not get in…believe me -he has more on the ball than most US doctors I have experience!

  193. The osteopathic DO degree is a very strong alternative to the US-trained MD degree. I strongly believe that one can be a great physician from a Caribbean school and have met a number of very competent graduates. However the osteopathic DO degree has a number of advantages to the MD Caribbean route.
    1)The biggest advantage is that most clinical rotations as a third and fourth year only accept students from US schools. (Varies from state to state, but this is generally so.) If you wanted to rotate at Dartmouth, Stanford, the University of California system, and the majority of the academic centers, they only accept students from US schools. It’s becoming harder and harder for Caribbean medical students to schedule their clinical rotations in the US because the majority of facilities don’t accept foreign medical students due to malpractice insurance etc.
    2)It is important to do clinical rotations at the University / community hospital / county hospital you want to end up at for residency. This is called an “audition rotation,” and is a way for program directors to get to know you, and put a face to your application when you apply. Doing audition rotations as a medical student gives you a huge advantage to matching at a residency and specialty you want to end up in.
    3) The majority of Universities / Hospitals now only accept digital applications via “VSAS.” This is the “Visiting Student Application Service” where medical students’ grades, immunizations, school malpractice information are sent to programs to set up “visiting rotations.” This service was originally only available to US + Canadian MD medical schools. But starting this year DO’s will also be a part of VSAS, which is a huge advantage. Unfortunately foreign / Caribbean MD schools won’t have this service and will still have to submit the paper forms to programs. Not only is the paper process been slow, inefficient, and a headache for my Carribean medical student friends, but it was also very difficult to get their schools to get back to them, or submit all the information on a timely manner. The biggest drawback to the paper method is that most programs no longer accept paper applications and only accept VSAS. In VSAS, you just set up your account, and select the schools from the drop down box of where you want to rotate as a 4th year medical student. This is a huge advantage for US trained students, because it got their foot in the door, was faster, and was in a format that programs want. This is why the DO programs are probably a better alternative pathway as opposed to a Caribbean MD school.
    4) If you are interested in emergency medicine, and other more competitive specialties, it is important to do rotations as a 4th year in this discipline. I know some friends at Ross who had an incredibly hard time setting up ER rotations. That’s why the Caribbean schools may not require Emergency Medicine as a required rotation to graduate because it is so hard to set up. It’s not fair, but that’s just the way that it is.
    5) The match rate to ACGME residencies is higher for DO’s than Carribean MD’s. Just the inherent preference, or perhaps their ability to do rotations in the university setting? DO’s match into the ACGME at around 70% per year. US-Citizen Caribbean graduates match into ACGME residencies at around 48 – 51%. Non-US-Citizen foreign medical graduates have the worst match rate at the low 40% every year. If you look at the NRMP website, you can see the trend, and also notice the foreign medical graduate match rate is creeping downward too. If a DO doesn’t match in the ACGME residency, they still have the advantage of going through to AOA residency match, which is another advantage.
    Again I don’t want to offend anybody, I think Caribbean MD’s can be amazing doctors. Medical school is really what you make of it, to be honest. Only your determination and amount of studying will make you competent. But the DO route is a much better alternative. DO’s are treated the same in the hospital setting. My younger sibling is in a DO school at Western University and my fiance is at a Caribbean MD school : St. Georges’ University. So I think I can offer an unbiased opinion by seeing what they are going through.

  194. One other thing to consider would be costs of attendance. Caribbean schools have a rather nasty practice of making you repeat your entire quarter a year later if you fail a single test, and of course require that you pay tuition a second time. This means a single mistake with an exam in the ~70% range can cost you $15-20k in extra tuition plus an extra year of interest that adds up with your loans. Added to an already very high price tag tuition can cost far more than you might initially expect, with some graduates taking on over 400k in debt (if they graduate). DO schools in comparison will likely cost less in the long term, allow you to stay in the USA, and have higher match % results.
    For those who do match and go on through residency, I have practiced with, and been taught by both US MD, Foreign MD, and DO and have seen an equal mix of great to bad between them. So after the residency match I’d say it’s all fair game again…just like trying to get into medical school from less prestigious colleges.

  195. 1) MD
    2) DO
    3) Pod

    I would never apply Caribbean…with the current residency situation it isn’t a viable option anymore. Go DO or Pod instead.

  196. How good is the CMU(Caribbean Medical Uni)? I see them advertising all over the place with ther USMLE pass rate of 75% above.

  197. Just graduated from SGU with a residency.
    All I can say is avoid this school if you possibly can. The teaching especially second year is horrible and the school once you’re hooked in is unapologetically not interested in anything remotely like preparing you for step exams of service as a physician.
    They are attentive to arranging your school loans – which are excessive even usurious.

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